Healthcare Provider Details

I. General information

NPI: 1780903997
Provider Name (Legal Business Name): SUSAN KLEIN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUSAN COLLIER

II. Dates (important events)

Enumeration Date: 05/27/2010
Last Update Date: 03/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 MILL ST GROUND FLOOR - TAHOE TOWER
RENO NV
89502-1576
US

IV. Provider business mailing address

850 HARVARD WAY
RENO NV
89502-2055
US

V. Phone/Fax

Practice location:
  • Phone: 775-982-6450
  • Fax: 775-982-3983
Mailing address:
  • Phone: 775-982-5262
  • Fax: 775-982-5496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN46642
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN001202
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: