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NPI Code Detail

MEDICARE: ALICIA NELSON RN

MEDICARE: ALICIA NELSON RN
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
1163WH0200XHome Health Registered NurseRN75087NV

General Provider Information

NPI Number : 1285405647
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICIA NELSON RN
Provider Business Mailing Address
First Line : 7940 CONSTANTINOPLE AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89129-5599
Country : US
Telephone Number : 702-374-9055
Fax Number :
Provider Business Practice Location Address
First Line : 250 PILOT RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-3542
Country : US
Telephone Number : 702-982-3292
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2024
Last Update Date : 01/12/2024

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