Healthcare Provider Details

I. General information

NPI: 1679776017
Provider Name (Legal Business Name): LEORA BETH SAPIR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 11/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5590 KIETZKE LN
RENO NV
89511-3019
US

IV. Provider business mailing address

5590 KIETZKE LN
RENO NV
89511-3019
US

V. Phone/Fax

Practice location:
  • Phone: 775-323-2080
  • Fax: 775-323-8216
Mailing address:
  • Phone: 775-323-2080
  • Fax: 775-323-8216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN00389
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberNP6086
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberNP6086
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: