Healthcare Provider Details

I. General information

NPI: 1225876345
Provider Name (Legal Business Name): LIEN TRACY DANG APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2024
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 W 6TH ST
RENO NV
89503-4548
US

IV. Provider business mailing address

690 E PATRICIAN DR
RENO NV
89506-5662
US

V. Phone/Fax

Practice location:
  • Phone: 775-770-3000
  • Fax:
Mailing address:
  • Phone: 941-268-1689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number892781
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11033976
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: