Healthcare Provider Details

I. General information

NPI: 1720996523
Provider Name (Legal Business Name): WESTERN NEVADA PRIMARY CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 E PRATER WAY
SPARKS NV
89434-8938
US

IV. Provider business mailing address

1959 E PRATER WAY
SPARKS NV
89434-8938
US

V. Phone/Fax

Practice location:
  • Phone: 775-519-4840
  • Fax:
Mailing address:
  • Phone: 775-519-4840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. DENISE CARMACK
Title or Position: OWNER
Credential: APRN
Phone: 775-741-2273