Healthcare Provider Details
I. General information
NPI: 1629238332
Provider Name (Legal Business Name): SARA ANNE HEALY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/16/2008
Last Update Date: 04/27/2023
Certification Date: 04/27/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
75 PRINGLE WAY STE 505
RENO NV
89502-1469
US
IV. Provider business mailing address
850 HARVARD WAY
RENO NV
89502-2055
US
V. Phone/Fax
- Phone: 775-982-5437
- Fax: 775-982-3895
- Phone: 775-982-5262
- Fax: 775-982-5496
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080P0208X |
| Taxonomy | Pediatric Infectious Diseases Physician |
| License Number | M-13434 |
| License Number State | ID |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080P0208X |
| Taxonomy | Pediatric Infectious Diseases Physician |
| License Number | MD60019801 |
| License Number State | WA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0208X |
| Taxonomy | Pediatric Infectious Diseases Physician |
| License Number | 17574 |
| License Number State | NV |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: