Healthcare Provider Details

I. General information

NPI: 1730397498
Provider Name (Legal Business Name): NORTHERN NEVADA ALLERGY CLINIC, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
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
US

IV. Provider business mailing address

8610 TECHNOLOGY WAY
RENO NV
89521
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 Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFFREY S. NUGENT
Title or Position: PRESIDENT
Credential: M.D.
Phone: 775-826-4900