MEDICARE: MS. NICOLE MARA

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1730569930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NICOLE MARA

Provider Business Mailing Address
First Line	:	3094 RESEARCH WAY STE 61
Second Line	:
City	:	CARSON CITY
State	:	NV
Zip	:	89706-7964
Country	:	US
Telephone Number	:	775-350-7977
Fax Number	:

Provider Business Practice Location Address
First Line	:	3094 RESEARCH WAY STE 61
Second Line	:
City	:	CARSON CITY
State	:	NV
Zip	:	89706-7964
Country	:	US
Telephone Number	:	775-350-7977
Fax Number	:

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

Provider Enumeration Date	:	06/02/2015
Last Update Date	:	07/07/2025

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