=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578279378
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | REBECCA BUSTOS DUARTE MSN, FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/25/2023
-----------------------------------------------------
Last Update Date | 08/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 499 W PLUMB LN STE 203
-----------------------------------------------------
City | RENO
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89509-3783
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-365-9542
-----------------------------------------------------
Fax | 775-365-9542
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 499 W PLUMB LN STE 203
-----------------------------------------------------
City | RENO
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89509-3783
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-365-9542
-----------------------------------------------------
Fax | 775-242-4542
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 271637
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------