MEDICARE: KALLIE ANN KAPPES O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	973	NV

General Provider Information

NPI Number	:	1265915961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KALLIE ANN KAPPES O.D.

Provider Business Mailing Address
First Line	:	6360 MAE ANNE AVE STE 1
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89523-4719
Country	:	US
Telephone Number	:	775-787-9137
Fax Number	:	775-323-3652

Provider Business Practice Location Address
First Line	:	6360 MAE ANNE AVE STE 1
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89523-4719
Country	:	US
Telephone Number	:	775-787-9137
Fax Number	:	775-323-3652

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2018
Last Update Date	:	08/06/2025

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