Provider Demographics
NPI:1063903086
Name:DELOACH, ALISHA MICHELLE
Entity type:Individual
Prefix:MRS
First Name:ALISHA
Middle Name:MICHELLE
Last Name:DELOACH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 WALTHAM HILLS ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-5837
Mailing Address - Country:US
Mailing Address - Phone:702-619-0368
Mailing Address - Fax:702-909-0368
Practice Address - Street 1:721 WALTHAM HILLS ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-5837
Practice Address - Country:US
Practice Address - Phone:702-619-0368
Practice Address - Fax:702-909-0368
Is Sole Proprietor?:No
Enumeration Date:2018-05-24
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider