Healthcare Provider Details

I. General information

NPI: 1891220844
Provider Name (Legal Business Name): LAUREN MONTEMORANO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2017
Last Update Date: 07/05/2024
Certification Date: 07/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5465 RENO CORPORATE DR STE 100
RENO NV
89511-2250
US

IV. Provider business mailing address

5465 RENO CORPORATE DR STE 100
RENO NV
89511-2250
US

V. Phone/Fax

Practice location:
  • Phone: 775-327-4673
  • Fax:
Mailing address:
  • Phone: 775-327-4673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number7483920
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number25041
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: