Healthcare Provider Details
I. General information
NPI: 1275088205
Provider Name (Legal Business Name): ALEXA CARROZZA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/19/2016
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6600 W CHARLESTON BLVD STE 142
LAS VEGAS NV
89146-1050
US
IV. Provider business mailing address
PO BOX 853
LOGANDALE NV
89021-0853
US
V. Phone/Fax
- Phone: 702-440-8430
- Fax: 866-640-0525
- Phone: 702-934-9900
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | APRN002368 |
| License Number State | NV |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: