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General NPI Number Information
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NPI Number | 1316785595
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Entity Type | Individual
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Provider Name | ALYSSA PATRICIA MANESE DE LUNA BSN, RN
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Gender | Female
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Dates
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Enumeration Date | 07/19/2024
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Last Update Date | 07/19/2024
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Provider Practice Location Address
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Address Line | 5155 S DURANGO DR STE 101
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City | LAS VEGAS
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State | NV
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Zip | 89113-0174
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Country | US
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Telephone | 702-869-4401
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Fax |
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Provider Business Mailing Address
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Address Line | 9621 DRAYTON AVE
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City | LAS VEGAS
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State | NV
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Zip | 89148-4623
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Country | US
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Telephone | 714-616-9173
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 874596
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License Number State | NV
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