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General NPI Number Information
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NPI Number | 1679961338
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Entity Type | Organization
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Legal Business Name | PRN APRN LTD
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Dates
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Enumeration Date | 01/05/2015
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Last Update Date | 01/05/2015
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Provider Practice Location Address
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Address Line | 456 MICHELE WAY
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City | SPARKS
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State | NV
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Zip | 89431-1256
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Country | US
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Telephone | 775-722-2410
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Fax |
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Provider Business Mailing Address
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Address Line | 456 MICHELE WAY
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City | SPARKS
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State | NV
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Zip | 89431-1256
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Country | US
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Telephone | 775-722-2410
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Fax |
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Authorized Official
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Title or Position | MANAGING OWNER
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Name | CYNTHIA A DAVIS
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Credential | APRN
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Telephone | 775-722-2410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN 000876
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License Number State | NV
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