Provider Demographics
NPI:1326280959
Name:TREVORAH, JANE CHIE (APRN)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:CHIE
Last Name:TREVORAH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:CHIE
Other - Last Name:MORIKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 15645
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89114-5645
Mailing Address - Country:US
Mailing Address - Phone:702-243-8566
Mailing Address - Fax:702-242-1535
Practice Address - Street 1:2704 N TENAYA WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0424
Practice Address - Country:US
Practice Address - Phone:702-243-8566
Practice Address - Fax:702-242-1535
Is Sole Proprietor?:No
Enumeration Date:2009-03-27
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN000567207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology