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General NPI Number Information
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NPI Number | 1982336160
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Entity Type | Organization
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Legal Business Name | INSPIRE SIERRA, LLC
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Dates
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Enumeration Date | 06/27/2022
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Last Update Date | 06/27/2022
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Provider Practice Location Address
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Address Line | 770 TRADEMARK DR STE 100
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City | RENO
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State | NV
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Zip | 89521-5926
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Country | US
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Telephone | 775-813-4288
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Fax |
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Provider Business Mailing Address
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Address Line | 770 TRADEMARK DR STE 100
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City | RENO
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State | NV
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Zip | 89521-5926
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Country | US
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Telephone | 775-813-4288
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. NICOLE PAVLATOS-DELAVOYE
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Credential | MD
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Telephone | 773-827-7511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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