Most Relevant Information
Provider Data
| NPI Number: | 1003649146 |
| Provider Name: | SARA AZEVEDO DONOVAN, |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 868504 |
Most Important Dates
| Enumeration Date: | 08/23/2024 |
| Last Updated: | 08/23/2024 |
Provider Practice Location
4040 S EASTERN AVE STE 300
LAS VEGAS
NV
891190854
Practice Location Phone/Fax
| Phone: | 7024630300 |
| Fax: |
Provider Mailing Location
4040 S EASTERN AVE STE 300
LAS VEGAS
NV
891190854
Provider Mailing Phone/Fax
| Phone: | 7024630300 |
| Fax: |