Provider Demographics
NPI:1437867926
Name:CALLAHAN, KATIE (FNP)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:PATRICIA
Other - Last Name:CALLAHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:975 RYLAND ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1667
Mailing Address - Country:US
Mailing Address - Phone:775-982-5000
Mailing Address - Fax:
Practice Address - Street 1:975 RYLAND ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1667
Practice Address - Country:US
Practice Address - Phone:775-982-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0000000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily