Healthcare Provider Details

I. General information

NPI: 1598019499
Provider Name (Legal Business Name): MR. ERIK SEMBACH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2012
Last Update Date: 10/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7415 INDIAN SPRINGS DR
SPARKS NV
89436-5669
US

IV. Provider business mailing address

7415 INDIAN SPRINGS DR
SPARKS NV
89436-5669
US

V. Phone/Fax

Practice location:
  • Phone: 775-424-2151
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN38717
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN38717
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN38717
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: