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NPI Code Detail

MEDICARE: STATE OF NEVADA

MEDICARE: STATE OF NEVADA
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
1251B00000XCase Management Agency
2252Y00000XEarly Intervention Provider Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952408239
Entity Type Code : Organization
Provider Name (Legal Business Name) : STATE OF NEVADA
Provider Business Mailing Address
First Line : 2667 ENTERPRISE RD
Second Line :
City : RENO
State : NV
Zip : 89512-1666
Country : US
Telephone Number : 775-688-1341
Fax Number : 775-688-2984
Provider Business Practice Location Address
First Line : 2667 ENTERPRISE RD
Second Line :
City : RENO
State : NV
Zip : 89512-1666
Country : US
Telephone Number : 775-688-1341
Fax Number : 775-688-2984
Authorized Official
Title or Position : ACCOUNTANT TECH I
Name : MS. MERRYLYN MERCER
Credential :
Telephone Number : 775-687-2484
Provider Enumeration Date : 09/20/2006
Last Update Date : 12/31/2019

Similar Medicare Providers

1376262675 — COLLEEN MARY MCKINSTRIE MFT
Practice Location Address:
2655 ENTERPRISE RD
RENO, NV
89512-1666
Practice Phone: 775-688-2427
Practice Fax:
1902481500 — JAHAHI CONTRERAS
Practice Location Address:
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89512-1666
Practice Phone: 775-688-1600
Practice Fax:
1306697750 — BRIANNA HAILEY JORGENSEN
Practice Location Address:
2655 ENTERPRISE RD
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89512-1666
Practice Phone: 775-688-2472
Practice Fax:
1952970741 — JACLYN MICHELLE WINDSOR DIAZ LCSW
Practice Location Address:
2655 ENTERPRISE RD
RENO, NV
89512-1666
Practice Phone: 775-688-2469
Practice Fax:
1033289392 — WILLIAM FREDERICK HARVEY LCSW
Practice Location Address:
2655 ENTERPRISE RD
RENO, NV
89512-1666
Practice Phone: 775-688-1600
Practice Fax: 775-688-1616
1184794547 — MS. JOYCE LARSEN LMFT
Practice Location Address:
2655 ENTERPRISE RD
RENO, NV
89512-1666
Practice Phone: 775-688-1600
Practice Fax: 775-688-1616

Directions to “STATE OF NEVADA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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