Healthcare Provider Details

I. General information

NPI: 1992068415
Provider Name (Legal Business Name): KRISTIN SOHN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2012
Last Update Date: 05/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 MILL ST
RENO NV
89502-1576
US

IV. Provider business mailing address

1155 MILL ST
RENO NV
89502-1576
US

V. Phone/Fax

Practice location:
  • Phone: 775-982-7890
  • Fax:
Mailing address:
  • Phone: 775-982-7890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA129311
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number17540
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number17540
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: