Provider Demographics
NPI:1801028931
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:Other Name
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 1:485 'B' STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:FALLON
Practice Address - State:NV
Practice Address - Zip Code:89406-2765
Practice Address - Country:US
Practice Address - Phone:775-423-4434
Practice Address - Fax:775-423-0422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-24
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care