Healthcare Provider Details

I. General information

NPI: 1831882760
Provider Name (Legal Business Name): ANGELA DAWN SCHALLA RESPIRATORY THERAPIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2023
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17629 ELK CT
RENO NV
89508-5025
US

IV. Provider business mailing address

17629 ELK CT
RENO NV
89508-5025
US

V. Phone/Fax

Practice location:
  • Phone: 775-315-3171
  • Fax:
Mailing address:
  • Phone: 775-315-3171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License NumberRC2570
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: