Healthcare Provider Details

I. General information

NPI: 1790378446
Provider Name (Legal Business Name): MARY EDITH SELLARS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2021
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

699 SIERRA ROSE DR. UNITS A & B
RENO NV
89511
US

IV. Provider business mailing address

PO BOX 21283
CARSON CITY NV
89721-1283
US

V. Phone/Fax

Practice location:
  • Phone: 775-204-4000
  • Fax: 775-234-4605
Mailing address:
  • Phone: 775-671-4531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number847775
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN63130
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: