Jacavone, Lisa Ellen

Jacavone, Lisa Ellen is an sole proprietor health care provider with primary practice located at 830 Chalkstone Ave , Providence RI 02908-4734. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is her primary health care specialty. Jacavone, Lisa Ellen can be contacted via phone (401) 273-7100.

Contact Information

Primary practice address
830 Chalkstone Ave Providence RI 02908-4734
Phone: (401) 273-7100
Fax: (401) 459-4797
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X RN36765 Rhode Island
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X NPP37867 Rhode Island
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X APRN01777 Rhode Island
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X RN2274406 Massachusetts

Profile Details

NPI number 1801084751
LBN Legal business name Jacavone, Lisa Ellen
Credentials RN/NP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 4th, 2007
Last updated Jan 24th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801084751 NPPES
Rhode Island Other APRN01777 ADVANCED PRACTICE REGISTERED NURSE LICENSE
Rhode Island Other CNP2274406 ADVANCED PRACTICE REGISTERED NURSE LICENSE

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