MEDICARE: SHARON A REDERFORD ARNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN002438	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	4098	OTHER		INTERNAL ID-MOTOR VEHICLE ID
4	1891870614	OTHER	WA	PSYCHIATRIY

General Provider Information

NPI Number	:	1891870614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON A REDERFORD ARNP

Provider Business Mailing Address
First Line	:	3732 LAKESIDE DR
Second Line	:	STE 202
City	:	RENO
State	:	NV
Zip	:	89509-4519
Country	:	US
Telephone Number	:	775-376-8274
Fax Number	:	775-470-6636

Provider Business Practice Location Address
First Line	:	3732 LAKESIDE DR STE 202
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89509-4519
Country	:	US
Telephone Number	:	775-626-0974
Fax Number	:	775-470-6636

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

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	05/04/2022

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