Individual
LOVELY JACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
314 QUITO CT, HENDERSON, NV 89014-5125
(702) 979-0389
Mailing address
314 QUITO CT, HENDERSON, NV 89014-5125
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
869086
NV
Other
Enumeration date
09/01/2025
Last updated
09/01/2025
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