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NPI Code Detail

MEDICARE: ALLY NEUROMEDICAL, LLC

MEDICARE: ALLY NEUROMEDICAL, LLC
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 Practitioner

General Provider Information

NPI Number : 1194662692
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALLY NEUROMEDICAL, LLC
Provider Business Mailing Address
First Line : 5470 KIETZKE LN STE 314
Second Line :
City : RENO
State : NV
Zip : 89511-3023
Country : US
Telephone Number : 775-538-0880
Fax Number : 775-372-2166
Provider Business Practice Location Address
First Line : 5470 KIETZKE LN STE 314
Second Line :
City : RENO
State : NV
Zip : 89511-3023
Country : US
Telephone Number : 775-538-0880
Fax Number : 775-372-2166
Authorized Official
Title or Position : PRESIDENT
Name : MRS. RACHAEL ELIZABETH GREGORY
Credential : APRN
Telephone Number : 775-762-8139
Provider Enumeration Date : 05/01/2026
Last Update Date : 06/18/2026

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Directions to “ALLY NEUROMEDICAL, LLC ” Practice Location

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