Healthcare Provider Details

I. General information

NPI: 1609686765
Provider Name (Legal Business Name): JENNIFER OLVEDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2025
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 DAMONTE RANCH PKWY
RENO NV
89521-5912
US

IV. Provider business mailing address

500 DAMONTE RANCH PKWY
RENO NV
89521-5912
US

V. Phone/Fax

Practice location:
  • Phone: 775-828-1000
  • Fax:
Mailing address:
  • Phone: 775-828-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN82428
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: