MEDICARE: KATHY REESE STINSON MD, PHD

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
1	207P00000X	Emergency Medicine Physician	11836	NV
2	207Q00000X	Family Medicine Physician	11836	NV
3	207V00000X	Obstetrics & Gynecology Physician	11836	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11035934	OTHER		CAQH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285674630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHY REESE STINSON MD, PHD

Provider Business Mailing Address
First Line	:	780 KUENZLI ST
Second Line	:	STE 202
City	:	RENO
State	:	NV
Zip	:	89502-0837
Country	:	US
Telephone Number	:	775-982-4590
Fax Number	:	775-982-4595

Provider Business Practice Location Address
First Line	:	560 E WILLIAMS AVE
Second Line	:
City	:	FALLON
State	:	NV
Zip	:	89406-3031
Country	:	US
Telephone Number	:	775-428-2022
Fax Number	:	775-428-2024

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	02/13/2013

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