Provider Demographics
NPI:1710154091
Name:SABINIANO, MARISSA GAVINO (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARISSA
Middle Name:GAVINO
Last Name:SABINIANO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9805 PESEO CRESTA AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-7501
Mailing Address - Country:US
Mailing Address - Phone:702-243-0074
Mailing Address - Fax:
Practice Address - Street 1:1650 COMMUNITY COLLEGE DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-1144
Practice Address - Country:US
Practice Address - Phone:702-486-0752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN23526163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse