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NPI Code Detail

MEDICARE: RHODORA NEU NURSE PRACTITIONER

MEDICARE: RHODORA NEU NURSE PRACTITIONER
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
1363LF0000XFamily Nurse Practitioner95003566CA
2363LG0600XGerontology Nurse Practitioner95003566NV

General Provider Information

NPI Number : 1427413947
Entity Type Code : Individual
Provider Name (Legal Business Name) : RHODORA NEU NURSE PRACTITIONER
Provider Business Mailing Address
First Line : 3101 PLUMAS ST STE 250
Second Line :
City : RENO
State : NV
Zip : 89509-4515
Country : US
Telephone Number : 775-829-7220
Fax Number :
Provider Business Practice Location Address
First Line : 3101 PLUMAS ST STE 250
Second Line :
City : RENO
State : NV
Zip : 89509-4515
Country : US
Telephone Number : 775-829-7220
Fax Number : 562-803-4500
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2015
Last Update Date : 11/08/2022

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Directions to “ RHODORA NEU NURSE PRACTITIONER” Practice Location

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