Provider Demographics
NPI:1164269494
Name:SAVON, JACQUE A (LPN)
Entity type:Individual
Prefix:
First Name:JACQUE
Middle Name:A
Last Name:SAVON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 N TORREY PINES DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-3375
Mailing Address - Country:US
Mailing Address - Phone:725-236-5884
Mailing Address - Fax:
Practice Address - Street 1:2950 E FLAMINGO RD STE H
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5208
Practice Address - Country:US
Practice Address - Phone:725-236-5884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV829356163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health