Provider Demographics
NPI:1134339039
Name:LAMERDIN, MAUREEN RENEE (OMD)
Entity type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:RENEE
Last Name:LAMERDIN
Suffix:
Gender:F
Credentials:OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6478 ARROYO VISTA LN
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-9363
Mailing Address - Country:US
Mailing Address - Phone:775-450-1065
Mailing Address - Fax:
Practice Address - Street 1:304 W FIFTH ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-4604
Practice Address - Country:US
Practice Address - Phone:775-841-3336
Practice Address - Fax:775-841-3337
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1002171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist