Healthcare Provider Details

I. General information

NPI: 1861664112
Provider Name (Legal Business Name): TERRY L. MCCASKILL M.D. PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2008
Last Update Date: 05/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6512 S MCCARRAN BLVD SUITE D
RENO NV
89509-6170
US

IV. Provider business mailing address

6512 S MCCARRAN BLVD SUITE D
RENO NV
89509-6170
US

V. Phone/Fax

Practice location:
  • Phone: 775-826-1285
  • Fax: 775-284-4093
Mailing address:
  • Phone: 775-826-1285
  • Fax: 775-284-4093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number4624
License Number StateNV

VIII. Authorized Official

Name: ROBIN LISTMAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 775-826-1285