Basic Information
| Provider Information | |||||||||
| NPI: | 1023773744 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DESSABLES | ||||||||
| FirstName: | ALEXA | ||||||||
| MiddleName: | NICOLE | ||||||||
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| Credential: | RN, BSN, CCRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11194 E BECK LN | ||||||||
| Address2: | |||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852551825 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4802161313 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1305 N MARTIN AVE | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857210001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206266154 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2021 | ||||||||
| LastUpdateDate: | 11/08/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC0200X | RN184086 | AZ | Y | Nursing Service Providers | Registered Nurse | Critical Care Medicine |
No ID Information.