Provider Demographics
NPI:1891042974
Name:SHROFF, SAVNEET GILL (MSN, APN)
Entity Type:Individual
Prefix:
First Name:SAVNEET
Middle Name:GILL
Last Name:SHROFF
Suffix:
Gender:F
Credentials:MSN, APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:702-579-3298
Mailing Address - Fax:702-667-4689
Practice Address - Street 1:2716 N TENAYA WAY
Practice Address - Street 2:SUITE 150
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0424
Practice Address - Country:US
Practice Address - Phone:702-240-8934
Practice Address - Fax:702-869-2436
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN001390363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1891042974Medicaid
NV1891042974Medicaid