Provider Demographics
NPI:1053845719
Name:ALEXANDER, CAVAWNTAY
Entity Type:Individual
Prefix:
First Name:CAVAWNTAY
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 E WARM SPRINGS RD STE 103
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-4248
Mailing Address - Country:US
Mailing Address - Phone:702-325-6910
Mailing Address - Fax:
Practice Address - Street 1:215 E WARM SPRINGS RD STE 103
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-4248
Practice Address - Country:US
Practice Address - Phone:702-325-6910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-19
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other