Healthcare Provider Details

I. General information

NPI: 1013851286
Provider Name (Legal Business Name): ANNE MARGARET MAGBOO ENRIQUEZ BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5420 KIETZKE LN STE 202
RENO NV
89511-2062
US

IV. Provider business mailing address

5420 KIETZKE LN STE 202
RENO NV
89511-2062
US

V. Phone/Fax

Practice location:
  • Phone: 775-338-8494
  • Fax:
Mailing address:
  • Phone: 775-338-8494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number879806
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: