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General NPI Number Information
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NPI Number | 1982360137
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Entity Type | Organization
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Legal Business Name | SAGEBRUSH PSYCHIATRY, PLLC
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Dates
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Enumeration Date | 11/11/2021
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 5470 KIETZKE LN STE 300
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City | RENO
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State | NV
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Zip | 89511-2099
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Country | US
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Telephone | 775-410-0189
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Fax | 775-339-0105
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Provider Business Mailing Address
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Address Line | 11885 CLAIM STAKE DR
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City | RENO
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State | NV
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Zip | 89506-7540
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Country | US
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Telephone | 512-436-5841
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Fax | 775-339-0105
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Authorized Official
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Title or Position | FOUNDER
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Name | JEFFREY WRIGHT BAYLESS
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Credential | PMHNP-BC
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Telephone | 512-436-5841
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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