=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396483491
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALEXIS LOMAX DOULA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/26/2022
-----------------------------------------------------
Last Update Date | 05/26/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6130 ELTON AVE
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89107-2538
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 725-270-4126
-----------------------------------------------------
Fax | 702-462-8465
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2449 N TENAYA WAY STE 36581
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89128-9995
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 725-270-4126
-----------------------------------------------------
Fax | 702-462-8465
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374J00000X
-----------------------------------------------------
Taxonomy Name | Doula
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------