MEDICARE: ANGELA ALESI

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP04572	LA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN815670	NV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4H442CU00	OTHER		MEDICARE

General Provider Information

NPI Number	:	1760411318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA ALESI

Provider Business Mailing Address
First Line	:	PO BOX 752003
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89136-2003
Country	:	US
Telephone Number	:	337-504-2332
Fax Number	:	337-504-4748

Provider Business Practice Location Address
First Line	:	911 N BUFFALO DR UNIT 213
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0381
Country	:	US
Telephone Number	:	702-405-8088
Fax Number	:

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

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	10/09/2019

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Directions to “ ANGELA ALESI ” Practice Location

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