Healthcare Provider Details

I. General information

NPI: 1760567770
Provider Name (Legal Business Name): PATRICIA LYNN SICHERMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 RIO VISTA ST
FALLON NV
89406-5463
US

IV. Provider business mailing address

1001 RIO VISTA ST
FALLON NV
89406-5463
US

V. Phone/Fax

Practice location:
  • Phone: 775-423-3634
  • Fax: 775-423-3246
Mailing address:
  • Phone: 775-423-3634
  • Fax: 775-423-3246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberRN18667
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: