Healthcare Provider Details

I. General information

NPI: 1508456880
Provider Name (Legal Business Name): BROOKE RIORDAN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/21/2021
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 PASTURE RD
FALLON NV
89496-5000
US

IV. Provider business mailing address

4755 PASTURE RD
FALLON NV
89496-5000
US

V. Phone/Fax

Practice location:
  • Phone: 754-263-1257
  • Fax:
Mailing address:
  • Phone: 754-263-1257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number28272
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: