Healthcare Provider Details

I. General information

NPI: 1457706327
Provider Name (Legal Business Name): MARIE LYN ELDER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARIE LYN GREER

II. Dates (important events)

Enumeration Date: 04/28/2016
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 KIRMAN AVE
RENO NV
89502-0997
US

IV. Provider business mailing address

704 W NYE LN STE 102
CARSON CITY NV
89703-1569
US

V. Phone/Fax

Practice location:
  • Phone: 757-867-2007
  • Fax: 775-785-7003
Mailing address:
  • Phone: 775-885-8890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN90514
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number823098
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: