MEDICARE: DR. AMY FORSBERG CONDON M.D.

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	207V00000X	Obstetrics & Gynecology Physician	16588	MS
2	207V00000X	Obstetrics & Gynecology Physician	16208	NV

General Provider Information

NPI Number	:	1336118173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMY FORSBERG CONDON M.D.

Provider Business Mailing Address
First Line	:	635 INNOVATION DR UNIT 300
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89511-2633
Country	:	US
Telephone Number	:	775-329-6241
Fax Number	:	775-329-4921

Provider Business Practice Location Address
First Line	:	901 E 2ND ST
Second Line	:	SUITE 307
City	:	RENO
State	:	NV
Zip	:	89502-1175
Country	:	US
Telephone Number	:	775-982-5000
Fax Number	:	775-982-3901

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

Provider Enumeration Date	:	03/15/2006
Last Update Date	:	04/29/2026

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