Basic Information
| Provider Information | |||||||||
| NPI: | 1356808679 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BEAUCHAMP | ||||||||
| FirstName: | ALYONA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10700 AMBER RIDGE DR UNIT 202 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891444448 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7022180915 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3016 W CHARLESTON BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891021973 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7022180915 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2019 | ||||||||
| LastUpdateDate: | 06/15/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 374U00000X | Y | Nursing Service Related Providers | Home Health Aide |
No ID Information.