Individual
GAOUSSOU SAVANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
35 BISSELL ST APT 1A, PROVIDENCE, RI 02907-3754
(646) 662-3857
Mailing address
PO BOX 40063, PROVIDENCE, RI 02940-0063
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
11643
RI
164W00000X
Licensed Practical Nurse
94732
MA
Other
Enumeration date
02/12/2020
Last updated
02/12/2020
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