Healthcare Provider Details

I. General information

NPI: 1245596055
Provider Name (Legal Business Name): THE MEDICAL PROFESSION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2012
Last Update Date: 10/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 RENO CORPORATE DR.
RENO NV
89511
US

IV. Provider business mailing address

5301 RENO CORPORATE DR.
RENO NV
89511
US

V. Phone/Fax

Practice location:
  • Phone: 775-329-5555
  • Fax: 775-827-4613
Mailing address:
  • Phone: 775-329-5555
  • Fax: 775-827-4613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberNV4312
License Number StateNV

VIII. Authorized Official

Name: DR. ROBIN WHITE
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 775-329-5555