Healthcare Provider Details

I. General information

NPI: 1083459978
Provider Name (Legal Business Name): AALIYAH BRIDGES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2024
Last Update Date: 07/01/2024
Certification Date: 07/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 E FLAMINGO RD STE H
LAS VEGAS NV
89121-5208
US

IV. Provider business mailing address

3650 E LAKE MEAD BLVD
LAS VEGAS NV
89115-7318
US

V. Phone/Fax

Practice location:
  • Phone: 725-251-3854
  • Fax:
Mailing address:
  • Phone: 702-583-1920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number871553
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: