Healthcare Provider Details

I. General information

NPI: 1326920372
Provider Name (Legal Business Name): ALEXIS KING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2025
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 N TENAYA WAY
LAS VEGAS NV
89128-0436
US

IV. Provider business mailing address

3 RED FAWN CT
HENDERSON NV
89074-6122
US

V. Phone/Fax

Practice location:
  • Phone: 702-962-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN99521
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: