Provider Demographics
NPI:1790126605
Name:SARKER, PROBIR (NP)
Entity Type:Individual
Prefix:
First Name:PROBIR
Middle Name:
Last Name:SARKER
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:PROBIR
Other - Middle Name:KUMAR
Other - Last Name:SARKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:411 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4415
Mailing Address - Country:US
Mailing Address - Phone:775-770-7600
Mailing Address - Fax:775-770-7880
Practice Address - Street 1:343 ELM ST
Practice Address - Street 2:SUITE 400
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4522
Practice Address - Country:US
Practice Address - Phone:775-770-6750
Practice Address - Fax:775-770-6755
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN73987163W00000X
NVAPRN002355363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse