Provider Demographics
NPI: | 1518199645 |
---|---|
Name: | NEVADA STATE HEALTH DIVISION/FAR NURSIN |
Entity Type: | Organization |
Organization Name: | NEVADA STATE HEALTH DIVISION/FAR NURSIN |
Other - Org Name: | FRONTIER AND RURAL PUBLIC HEALTH |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | DIRECTOR OF CLINICAL SERVICES, FAR/ |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | MARY |
Authorized Official - Middle Name: | E |
Authorized Official - Last Name: | WHERRY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | RN, MS |
Authorized Official - Phone: | 775-684-4018 |
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: | 89706-2028 |
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: | |
Practice Address - City: | DAYTON |
Practice Address - State: | NV |
Practice Address - Zip Code: | 89403-8803 |
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: | 2010-06-10 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251J00000X | Agencies | Nursing Care |