Provider Demographics
NPI:1265279889
Name:CUMMINGS, KAITLYN ANN (APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:ANN
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9920 BRIGHTRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89506-5547
Mailing Address - Country:US
Mailing Address - Phone:775-513-7658
Mailing Address - Fax:
Practice Address - Street 1:5375 RENO CORPORATE DR STE 100
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2381
Practice Address - Country:US
Practice Address - Phone:775-384-1134
Practice Address - Fax:775-284-1523
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-11
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV880152363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily