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Contact Information

JAIMIE D REVON, LPN
700 GAUSE BLVD STE 201
SLIDELL, LA70458-2853
 Phone: 504-330-6670
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Case Manager/Care Coordinator

171M00000X
 

Licensed Practical Nurse

164W00000X
Indicates primary specialty

NPI Profile & details for JAIMIE D REVON · (Female)

NPI Number 1881204022
Status Active
Credentials LPN (Licensed Practical Nurse)
Entity Individual
Enumeration date 08/03/2020
Last updated 08/03/2020 - About 6 years ago
Sole proprietor 1 Yes
Identifiers
  • LA License # 2-0160813
  • LA Medicaid 1881864
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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