Healthcare Provider Details

I. General information

NPI: 1871572768
Provider Name (Legal Business Name): JEFFREY S NUGENT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8610 TECHNOLOGY WAY
RENO NV
89521-5941
US

IV. Provider business mailing address

8610 TECHNOLOGY WAY
RENO NV
89521-5941
US

V. Phone/Fax

Practice location:
  • Phone: 775-826-4900
  • Fax: 775-826-3257
Mailing address:
  • Phone: 775-826-4900
  • Fax: 775-826-3257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number12085
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: