Healthcare Provider Details

I. General information

NPI: 1699249862
Provider Name (Legal Business Name): JAIME RUSCHE RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JAIME WHITTINGTON RN

II. Dates (important events)

Enumeration Date: 01/21/2019
Last Update Date: 10/11/2021
Certification Date: 10/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7375 PINEHURST CIR
RENO NV
89502-9739
US

IV. Provider business mailing address

7375 PINEHURST CIR
RENO NV
89502-9739
US

V. Phone/Fax

Practice location:
  • Phone: 775-338-9892
  • Fax:
Mailing address:
  • Phone: 775-338-9892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN49197
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: