Healthcare Provider Details

I. General information

NPI: 1114293370
Provider Name (Legal Business Name): JENNIFER MARIE CONTI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2012
Last Update Date: 09/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

748 S MEADOWS PKWY A9-366
RENO NV
89521-3861
US

IV. Provider business mailing address

8938 BEACON RIDGE TRL
RENO NV
89523-6805
US

V. Phone/Fax

Practice location:
  • Phone: 775-324-4040
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number16543
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: