Provider Demographics
NPI:1275629255
Name:EDNEY-WEARE, SALLY (RN)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:
Last Name:EDNEY-WEARE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 S WELLS AVE.
Mailing Address - Street 2:SUITE 120
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502
Mailing Address - Country:US
Mailing Address - Phone:775-329-6300
Mailing Address - Fax:775-348-3896
Practice Address - Street 1:1055 S WELLS AVE.
Practice Address - Street 2:SUITE 120
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502
Practice Address - Country:US
Practice Address - Phone:775-329-6300
Practice Address - Fax:775-348-3896
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN25785363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner