Provider Demographics
NPI:1821831009
Name:JARVIS, AMANDA NICOLE (CAREGIVER)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:NICOLE
Last Name:JARVIS
Suffix:
Gender:F
Credentials:CAREGIVER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 PARADISE RD APT 2082
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-4481
Mailing Address - Country:US
Mailing Address - Phone:302-688-5805
Mailing Address - Fax:
Practice Address - Street 1:3430 E FLAMINGO RD STE 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5064
Practice Address - Country:US
Practice Address - Phone:702-427-4000
Practice Address - Fax:725-217-1861
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide