Provider Demographics
NPI:1477183788
Name:SAILOR, SAIMONE SANDRA
Entity Type:Individual
Prefix:
First Name:SAIMONE
Middle Name:SANDRA
Last Name:SAILOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2589 PINE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89115-4335
Mailing Address - Country:US
Mailing Address - Phone:702-289-5267
Mailing Address - Fax:
Practice Address - Street 1:2589 PINE CREEK RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89115-4335
Practice Address - Country:US
Practice Address - Phone:702-289-5267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-26
Last Update Date:2020-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No172A00000XOther Service ProvidersDriver
No251E00000XAgenciesHome Health