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NPI Code Detail

MEDICARE: ALEJANDRA NALLELY OLIVARES HERNANDEZ

MEDICARE: ALEJANDRA NALLELY OLIVARES HERNANDEZ
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
11041C0700XClinical Social Worker12543-MNV
2225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1790671352
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEJANDRA NALLELY OLIVARES HERNANDEZ
Provider Business Mailing Address
First Line : 6402 MCLEOD DR STE 5
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-4406
Country : US
Telephone Number : 725-204-8809
Fax Number :
Provider Business Practice Location Address
First Line : 6402 MCLEOD DR STE 5
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-4406
Country : US
Telephone Number : 725-204-8809
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2025
Last Update Date : 12/12/2025

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Directions to “ ALEJANDRA NALLELY OLIVARES HERNANDEZ ” Practice Location

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