Provider Demographics
NPI:1619485208
Name:BROWN-GAY, ALXENIA P
Entity Type:Individual
Prefix:MS
First Name:ALXENIA
Middle Name:P
Last Name:BROWN-GAY
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 1:5150 SPYGLASS ST.
Mailing Address - Street 2:APT. 257
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89142
Mailing Address - Country:US
Mailing Address - Phone:818-570-4606
Mailing Address - Fax:702-293-3664
Practice Address - Street 1:5150 SPYGLASS ST.
Practice Address - Street 2:APT. 257
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89142
Practice Address - Country:US
Practice Address - Phone:818-570-4606
Practice Address - Fax:702-293-3664
Is Sole Proprietor?:No
Enumeration Date:2018-01-17
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV$$$$$$$$$Medicaid