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General NPI Number Information
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NPI Number | 1649699869
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Entity Type | Organization
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Legal Business Name | NORTHERN NEVADA HIV OUTPATIENT PROGRAM EDUCATION AND SERVICES
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 02/09/2021
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Provider Practice Location Address
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Address Line | 580 W 5TH ST
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City | RENO
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State | NV
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Zip | 89503-4407
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Country | US
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Telephone | 775-786-4673
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Fax | 775-348-2889
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Provider Business Mailing Address
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Address Line | 580 W 5TH ST
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City | RENO
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State | NV
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Zip | 89503-4407
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Country | US
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Telephone | 775-786-4673
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Fax | 775-348-2889
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Authorized Official
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Title or Position | CEO
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Name | SHARON CHAMBERLAIN
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Credential |
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Telephone | 775-786-4673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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