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General NPI Number Information
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NPI Number | 1881175867
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Entity Type | Individual
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Provider Name | JOLENE BEVAN
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Gender | Female
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Dates
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Enumeration Date | 08/27/2018
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Last Update Date | 08/27/2018
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Provider Practice Location Address
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Address Line | 160 E HORIZON DR STE A
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City | HENDERSON
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State | NV
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Zip | 89015-7934
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Country | US
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Telephone | 702-644-3600
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Fax | 702-719-5665
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Provider Business Mailing Address
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Address Line | 2120 RAMROD AVE APT 18
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City | HENDERSON
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State | NV
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Zip | 89014-2008
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Country | US
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Telephone | 702-834-1940
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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License Number |
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State | NV
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Taxonomy #4
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State | NV
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