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General NPI Number Information
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NPI Number | 1245643162
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Entity Type | Individual
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Provider Name | KAVITA GUPTA RN, BSN
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Gender | Female
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Dates
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Enumeration Date | 06/09/2014
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Last Update Date | 06/09/2014
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Provider Practice Location Address
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Address Line | 1001 RIO VISTA DR FALLON TRIBAL HEALTH CENTER
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City | FALLON
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State | NV
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Zip | 89406-5463
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Country | US
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Telephone | 775-423-3634
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Fax | 775-423-2314
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Provider Business Mailing Address
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Address Line | 1001 RIO VISTA DR FALLON TRIBAL HEALTH CENTER
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City | FALLON
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State | NV
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Zip | 89406-5463
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Country | US
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Telephone | 775-423-3634
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Fax | 775-423-2314
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN30453
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License Number State | NV
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