Provider Demographics
NPI:1023752722
Name:DEDUSHI, ALMA (APRN-FNP-C)
Entity type:Individual
Prefix:
First Name:ALMA
Middle Name:
Last Name:DEDUSHI
Suffix:
Gender:F
Credentials:APRN-FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 S RANCHO DR STE D34
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4874
Mailing Address - Country:US
Mailing Address - Phone:702-471-0051
Mailing Address - Fax:702-471-0107
Practice Address - Street 1:601 S RANCHO DR STE D34
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4874
Practice Address - Country:US
Practice Address - Phone:702-471-0051
Practice Address - Fax:702-471-0107
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-27
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV810211363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty