Provider Demographics
NPI:1083020770
Name:TUVESON, KELLY (DO)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:TUVESON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1155 MILL ST # MS 14
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1576
Mailing Address - Country:US
Mailing Address - Phone:775-982-5262
Mailing Address - Fax:775-982-5496
Practice Address - Street 1:75 PRINGLE WAY STE 505
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1469
Practice Address - Country:US
Practice Address - Phone:775-982-5437
Practice Address - Fax:775-982-3805
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
NVDO32632080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program