Healthcare Provider Details

I. General information

NPI: 1356164917
Provider Name (Legal Business Name): ADVANCED SURGICAL SPECIALISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2024
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7848 W SAHARA AVE
LAS VEGAS NV
89117-1944
US

IV. Provider business mailing address

5940 S RAINBOW BLVD # 895
LAS VEGAS NV
89118-2506
US

V. Phone/Fax

Practice location:
  • Phone: 702-321-0847
  • Fax: 702-745-2115
Mailing address:
  • Phone: 702-321-0847
  • Fax: 855-710-6303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ALECIA DANIELLE GRIMES
Title or Position: OWNER/NURSE PRACTITIONER
Credential: DNP, ARPN, AGACNP-BC
Phone: 702-321-0847