Healthcare Provider Details

I. General information

NPI: 1154393528
Provider Name (Legal Business Name): VERONICA M SUTHERLAND DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 03/17/2021
Certification Date: 03/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6630 S MCCARRAN BLVD STE 9
RENO NV
89509-6145
US

IV. Provider business mailing address

5975 S LOS ALTOS PKWY
SPARKS NV
89436-7699
US

V. Phone/Fax

Practice location:
  • Phone: 775-204-4000
  • Fax: 775-402-4001
Mailing address:
  • Phone: 775-204-4000
  • Fax: 775-204-4001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number3788
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number3788
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO1503
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: