Healthcare Provider Details

I. General information

NPI: 1881209476
Provider Name (Legal Business Name): CHRIS J BIRTWELL NRP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2020
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4343 WICKFORD WAY
MATHER CA
95655-3046
US

IV. Provider business mailing address

450 EDISON WAY
RENO NV
89502-4117
US

V. Phone/Fax

Practice location:
  • Phone: 916-769-1828
  • Fax:
Mailing address:
  • Phone: 775-858-5700
  • Fax: 775-353-0892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberP31208
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: