Healthcare Provider Details

I. General information

NPI: 1821907379
Provider Name (Legal Business Name): STEPHANIE HOLLY THEZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10315 PROFESSIONAL CIR STE 101
RENO NV
89521-4824
US

IV. Provider business mailing address

1705 BRONZE HILL RD
RENO NV
89506-3311
US

V. Phone/Fax

Practice location:
  • Phone: 510-246-1266
  • Fax:
Mailing address:
  • Phone: 510-246-1266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number872790
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: