Provider Demographics
NPI:1083889299
Name:DAVIS-ALSTON, MYRA (RN,MSN)
Entity Type:Individual
Prefix:MS
First Name:MYRA
Middle Name:
Last Name:DAVIS-ALSTON
Suffix:
Gender:F
Credentials:RN,MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 360001
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89036-8108
Mailing Address - Country:US
Mailing Address - Phone:702-636-3000
Mailing Address - Fax:
Practice Address - Street 1:3880 S JONES BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-2456
Practice Address - Country:US
Practice Address - Phone:702-636-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN11028163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse