IndividualActive
Alisha Provost, DO
NPI 1073142816 · Family Medicine Physician · Nellis Afb, NV
Provider details
- NPI number
- 1073142816
- Entity type
- Individual
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- DO
- Sex
- Female
- Sole proprietor
- No
- License
- 2022032506 (MO)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
4700 Las Vegas Blvd N
Nellis Afb, NV 89191-6600
Phone: (702) 653-2273
Approximate (ZIP-level) locationGet directions
Mailing address
4700 Las Vegas Blvd N
Nellis Afb, NV 89191-6600
Registry dates
- Enumerated
- 2020-04-03
- Last updated
- 2024-07-16
- Certified
- 2024-07-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.