Healthcare Provider Details

I. General information

NPI: 1992709976
Provider Name (Legal Business Name): NORTHERN NEVADA HIV OUTPATIENT PROGRAM, EDUCATION AND SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2005
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

580 W 5TH ST
RENO NV
89503-4407
US

IV. Provider business mailing address

580 W 5TH ST
RENO NV
89503-4407
US

V. Phone/Fax

Practice location:
  • Phone: 775-786-4673
  • Fax: 776-348-2889
Mailing address:
  • Phone: 775-786-4673
  • Fax: 776-348-2889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNV

VIII. Authorized Official

Name: FAITH WHITTIER
Title or Position: CMO
Credential:
Phone: 775-786-4673