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General NPI Number Information
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NPI Number | 1588577274
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Entity Type | Organization
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Legal Business Name | KINROSS ROUND MOUNTAIN GOLD CORPORATION
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Dates
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Enumeration Date | 09/24/2026
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Last Update Date | 09/24/2026
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Provider Practice Location Address
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Address Line | 1 SMOKY VALLEY MINE ROAD
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City | ROUND MOUNTAIN
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State | NV
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Zip | 89045
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Country | US
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Telephone | 775-377-3267
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Fax | 775-377-3368
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Provider Business Mailing Address
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Address Line | PO BOX 480
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City | ROUND MOUNTAIN
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State | NV
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Zip | 89045-0480
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Country | US
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Telephone | 775-377-3267
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Fax | 775-377-3368
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Authorized Official
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Title or Position | CLINIC SUPERVISOR
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Name | AMBER NICOLE CLARK
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Credential | RN
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Telephone | 775-377-3267
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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