Healthcare Provider Details

I. General information

NPI: 1568742278
Provider Name (Legal Business Name): MAILANI ESPIRITU RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2011
Last Update Date: 08/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 RENO HWY
FALLON NV
89406-2627
US

IV. Provider business mailing address

2020 RENO HWY
FALLON NV
89406-2627
US

V. Phone/Fax

Practice location:
  • Phone: 775-428-6409
  • Fax: 775-428-2826
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17117
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH59905
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: