Healthcare Provider Details
I. General information
NPI: 1245974237
Provider Name (Legal Business Name): COMPREHENSIVE MEN AND WOMEN'S HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/25/2022
Last Update Date: 02/16/2023
Certification Date: 02/16/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
343 ELM ST STE 201
RENO NV
89503-4538
US
IV. Provider business mailing address
343 ELM ST STE 201
RENO NV
89503-4538
US
V. Phone/Fax
- Phone: 775-470-6651
- Fax:
- Phone: 775-470-6651
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EDIN
ABDAGIC
Title or Position: PRESIDENT
Credential: CNP, MSN
Phone: 702-690-1633