| NPI | 1578334215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON VAN REKEN Manager 775-338-9279 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2024-01-11 |
| Last Update Date | 2024-05-10 |