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NPI Code Detail

MEDICARE: JANNA RAY CISNEROS

MEDICARE: JANNA RAY CISNEROS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner880422NV
2363LG0600XGerontology Nurse Practitioner880422NV

General Provider Information

NPI Number : 1053159459
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANNA RAY CISNEROS
Provider Business Mailing Address
First Line : 1155 MILL ST # MCM14
Second Line :
City : RENO
State : NV
Zip : 89502-1576
Country : US
Telephone Number : 775-982-5000
Fax Number :
Provider Business Practice Location Address
First Line : 10315 PROFESSIONAL CIR STE 101
Second Line :
City : RENO
State : NV
Zip : 89521-4802
Country : US
Telephone Number : 775-982-2828
Fax Number : 775-982-2834
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2024
Last Update Date : 01/12/2025

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Directions to “ JANNA RAY CISNEROS ” Practice Location

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