Provider Demographics
NPI:1376186668
Name:GRIMES, ALECIA (DNP, APRN, AGACNP-BC)
Entity Type:Individual
Prefix:MISS
First Name:ALECIA
Middle Name:
Last Name:GRIMES
Suffix:
Gender:F
Credentials:DNP, APRN, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7200 CATHEDRAL ROCK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0430
Mailing Address - Country:US
Mailing Address - Phone:702-723-4124
Mailing Address - Fax:702-867-0066
Practice Address - Street 1:7200 CATHEDRAL ROCK DR STE 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0430
Practice Address - Country:US
Practice Address - Phone:702-723-4124
Practice Address - Fax:702-867-0066
Is Sole Proprietor?:No
Enumeration Date:2019-10-20
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7298715-4405363LA2100X
NV845055363LA2100X, 363LA2100X, 163WM0705X
UT7298715-3102163W00000X, 163WR0006X
UT167189246ZS0410X
UT729875-3102163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant