MEDICARE: SARAH HAUNANI HERBERT FNP-BC

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	363LP2300X	Primary Care Nurse Practitioner	831768	NV

General Provider Information

NPI Number	:	1518570357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH HAUNANI HERBERT FNP-BC

Provider Business Mailing Address
First Line	:	1155 MILL ST # M14
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89502-1576
Country	:	US
Telephone Number	:	775-982-4270
Fax Number	:	775-980-4575

Provider Business Practice Location Address
First Line	:	2300 S CARSON ST STE 1
Second Line	:
City	:	CARSON CITY
State	:	NV
Zip	:	89701-4528
Country	:	US
Telephone Number	:	775-982-5000
Fax Number	:	775-982-3900

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

Provider Enumeration Date	:	08/30/2020
Last Update Date	:	12/07/2020

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