Healthcare Provider Details
I. General information
NPI: 1043419773
Provider Name (Legal Business Name): MS. JOANNE MARIE LENARES
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/12/2007
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1559 WATASHEAMU RD
GARDNERVILLE NV
89460-7455
US
IV. Provider business mailing address
1559 WATASHEAMU RD
GARDNERVILLE NV
89460-7455
US
V. Phone/Fax
- Phone: 775-265-4215
- Fax: 775-265-6071
- Phone: 775-265-4215
- Fax: 775-265-6071
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 246RP1900X |
| Taxonomy | Phlebotomy Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: