Healthcare Provider Details

I. General information

NPI: 1093651341
Provider Name (Legal Business Name): NICHOLE TRINA VONJAEGER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 E MAIN ST
FERNLEY NV
89408-9537
US

IV. Provider business mailing address

307 NIBLICK CT
YERINGTON NV
89447-2482
US

V. Phone/Fax

Practice location:
  • Phone: 775-575-3363
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number868272
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: