Individual
ALISSA FULLER SIDEBOTTOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
250 PILOT RD STE 250, LAS VEGAS, NV 89119-3514
(702) 982-3292
(702) 982-5286
Mailing address
730 OAKMONT AVE UNIT 909, LAS VEGAS, NV 89109-0109
(951) 216-4654
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
866517
NV
Other
Enumeration date
05/10/2024
Last updated
05/10/2024
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