Provider Demographics
NPI:1992571491
Name:ALOG, DONNA (MSN, APRN)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:ALOG
Suffix:
Gender:F
Credentials:MSN, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 N BUFFALO DR UNIT 213
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0381
Mailing Address - Country:US
Mailing Address - Phone:702-405-8088
Mailing Address - Fax:702-405-6066
Practice Address - Street 1:911 N BUFFALO DR UNIT 213
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0381
Practice Address - Country:US
Practice Address - Phone:702-405-8088
Practice Address - Fax:702-405-6066
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV820286363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health