Provider Demographics
NPI:1598546129
Name:ALONSO, LINDA MELISSA
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MELISSA
Last Name:ALONSO
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 1:4760 S PECOS RD STE 103
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-5828
Mailing Address - Country:US
Mailing Address - Phone:702-689-5710
Mailing Address - Fax:702-966-6313
Practice Address - Street 1:4760 S PECOS RD STE 103
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5828
Practice Address - Country:US
Practice Address - Phone:702-689-5710
Practice Address - Fax:702-966-6313
Is Sole Proprietor?:No
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant