Provider Demographics
NPI:1003649096
Name:SANDOVAL, ALEXANDER WADE (RNFA)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:WADE
Last Name:SANDOVAL
Suffix:
Gender:M
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1056 RICCO DR
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-6604
Mailing Address - Country:US
Mailing Address - Phone:775-354-7888
Mailing Address - Fax:
Practice Address - Street 1:1056 RICCO DR
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434-6604
Practice Address - Country:US
Practice Address - Phone:775-354-7888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN97838163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant