MEDICARE: ALEXANDRA DAVIS PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA1802	NV

General Provider Information

NPI Number	:	1093250805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA DAVIS PA-C

Provider Business Mailing Address
First Line	:	2800 N TENAYA WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0652
Country	:	US
Telephone Number	:	702-202-2700
Fax Number	:

Provider Business Practice Location Address
First Line	:	2800 N TENAYA WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0652
Country	:	US
Telephone Number	:	702-202-2700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2017
Last Update Date	:	11/04/2021

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