Healthcare Provider Details

I. General information

NPI: 1801286646
Provider Name (Legal Business Name): ALICE DREYFUS APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALICE NG

II. Dates (important events)

Enumeration Date: 02/02/2015
Last Update Date: 01/10/2023
Certification Date: 01/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 MESQUITE AVE
LAKE HAVASU CITY AZ
86403-5668
US

IV. Provider business mailing address

9097 W POST RD STE 100
LAS VEGAS NV
89148-2417
US

V. Phone/Fax

Practice location:
  • Phone: 928-854-5400
  • Fax:
Mailing address:
  • Phone: 702-430-5333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN001870
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60508961
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number283789
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: