=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932962925
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MOUNTAINVIEW MEDICAL ASSOCIATES PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/01/2024
-----------------------------------------------------
Last Update Date | 02/01/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1701 COUNTY RD STE H
-----------------------------------------------------
City | MINDEN
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89423-4465
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-782-3933
-----------------------------------------------------
Fax | 775-782-1127
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1701 COUNTY RD STE H
-----------------------------------------------------
City | MINDEN
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89423-4465
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-782-3933
-----------------------------------------------------
Fax | 775-782-1127
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | CAROL TUSANG SWARTZ
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 775-782-3933
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------