Healthcare Provider Details

I. General information

NPI: 1427660992
Provider Name (Legal Business Name): LARA KRISTINA SHIGIHARA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2020
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 PRINGLE WAY STE 801
RENO NV
89502-8400
US

IV. Provider business mailing address

1155 MILL ST # M14
RENO NV
89502-1576
US

V. Phone/Fax

Practice location:
  • Phone: 775-982-2820
  • Fax: 775-982-2821
Mailing address:
  • Phone: 775-982-2820
  • Fax: 775-982-2821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number829121
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: