Healthcare Provider Details

I. General information

NPI: 1386113546
Provider Name (Legal Business Name): ADVANCED PRACTICE PRIMARY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2018
Last Update Date: 07/03/2023
Certification Date: 07/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4773 CAUGHLIN PKWY
RENO NV
89519-1011
US

IV. Provider business mailing address

2825 HERO WAY
RENO NV
89521-4366
US

V. Phone/Fax

Practice location:
  • Phone: 775-683-8239
  • Fax: 775-683-9997
Mailing address:
  • Phone: 775-682-8239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: PAULINE STOLTZNER
Title or Position: APRN
Credential: FNP-BC, PMHNP-BC
Phone: 775-683-8239