Healthcare Provider Details

I. General information

NPI: 1881423689
Provider Name (Legal Business Name): ANGELA WHITTAKER AUDIOLOGY AND HEARING AIDS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2024
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6490 S MCCARRAN BLVD STE 29
RENO NV
89509-6124
US

IV. Provider business mailing address

6490 S MCCARRAN BLVD STE 29
RENO NV
89509-6124
US

V. Phone/Fax

Practice location:
  • Phone: 775-561-4327
  • Fax: 775-686-6160
Mailing address:
  • Phone: 775-561-4327
  • Fax: 775-686-6160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: DR. ANGELA WHITTAKER
Title or Position: AUDIOLOGIST/OWNER
Credential: AUD
Phone: 775-561-4327