Healthcare Provider Details

I. General information

NPI: 1194784397
Provider Name (Legal Business Name): RICHARD HAERING DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1879 CROCKETT LN
GARDNERVILLE NV
89410-6192
US

IV. Provider business mailing address

1879 CROCKETT LN
GARDNERVILLE NV
89410-6192
US

V. Phone/Fax

Practice location:
  • Phone: 775-750-8388
  • Fax:
Mailing address:
  • Phone: 775-750-8388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number800
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number800
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: