Provider Demographics
NPI:1497987515
Name:NEVADA STATE HEALTH DIVISION
Entity Type:Organization
Organization Name:NEVADA STATE HEALTH DIVISION
Other - Org Name:FRONTIER AND RURAL PUBLIC HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, FAR PROGRAM
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:S
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:RN, LNC
Authorized Official - Phone:775-684-4208
Mailing Address - Street 1:4150 TECHNOLOGY WAY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706
Mailing Address - Country:US
Mailing Address - Phone:775-684-5900
Mailing Address - Fax:775-684-3492
Practice Address - Street 1:34 LAKES BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:DAYTON
Practice Address - State:NV
Practice Address - Zip Code:89403
Practice Address - Country:US
Practice Address - Phone:775-246-6211
Practice Address - Fax:775-246-6312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare