Provider Demographics
NPI:1881209476
Name:BIRTWELL, CHRIS J
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:J
Last Name:BIRTWELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 EDISON WAY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-4117
Mailing Address - Country:US
Mailing Address - Phone:775-858-5700
Mailing Address - Fax:775-353-0892
Practice Address - Street 1:450 EDISON WAY
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-4117
Practice Address - Country:US
Practice Address - Phone:775-858-5700
Practice Address - Fax:775-353-0892
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV73672146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic