Provider Demographics
NPI:1649528142
Name:MCCROREY, THERESA MAUREEN (RN)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:MAUREEN
Last Name:MCCROREY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 DELUCCHI LN
Mailing Address - Street 2:SUITE #207
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-6578
Mailing Address - Country:US
Mailing Address - Phone:775-384-3587
Mailing Address - Fax:
Practice Address - Street 1:1575 DELUCCHI LN
Practice Address - Street 2:SUITE #207
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-6578
Practice Address - Country:US
Practice Address - Phone:775-384-3587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN71487163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse