Provider Demographics
NPI:1841821923
Name:GIOVANNETTI, DONALD EDWARD
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:EDWARD
Last Name:GIOVANNETTI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 STEFFANIE WAY
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-1219
Mailing Address - Country:US
Mailing Address - Phone:775-742-8213
Mailing Address - Fax:
Practice Address - Street 1:610 S 18TH ST
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-5518
Practice Address - Country:US
Practice Address - Phone:775-409-4286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9924-PCS-03747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant