Provider Demographics
NPI:1922802875
Name:MINK, ALLISON RAE
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:RAE
Last Name:MINK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 N GREEN VALLEY PKWY APT 724
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-5828
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2779 W HORIZON RIDGE PKWY STE 200
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4186
Practice Address - Country:US
Practice Address - Phone:702-990-2290
Practice Address - Fax:702-990-2297
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-05-20
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant