Healthcare Provider Details

I. General information

NPI: 1093018178
Provider Name (Legal Business Name): GAITREE SANDRA DEBIPARSHAD APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2010
Last Update Date: 01/10/2022
Certification Date: 01/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

727 FAIRVIEW DR
CARSON CITY NV
89701
US

IV. Provider business mailing address

727 FAIRVIEW DR
CARSON CITY NV
89701
US

V. Phone/Fax

Practice location:
  • Phone: 775-684-5000
  • Fax: 775-687-1181
Mailing address:
  • Phone: 775-684-5000
  • Fax: 775-687-1181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number766048
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP118356
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number833631
License Number StateNV
# 4
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number833631
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: