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General NPI Number Information
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NPI Number | 1730860396
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Entity Type | Individual
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Provider Name | EDWARD ALABANZA
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Gender | Male
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Dates
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Enumeration Date | 07/27/2023
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 302 E CARSON AVE STE 1004
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City | LAS VEGAS
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State | NV
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Zip | 89101-5909
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Country | US
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Telephone | 775-400-9764
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Fax |
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Provider Business Mailing Address
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Address Line | 6216 WINSTON FALLS AVE
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City | LAS VEGAS
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State | NV
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Zip | 89139-6869
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Country | US
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Telephone | 408-480-3690
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 833469
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 833469
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License Number State | NV
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