Provider Demographics
NPI:1881766871
Name:NIGRO, BRUCE A (APRN)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:A
Last Name:NIGRO
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 S ROCK BLVD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-4113
Mailing Address - Country:US
Mailing Address - Phone:775-870-4334
Mailing Address - Fax:775-870-4634
Practice Address - Street 1:5295 SUN VALLEY BLVD
Practice Address - Street 2:SUITE 5
Practice Address - City:SUN VALLEY
Practice Address - State:NV
Practice Address - Zip Code:89433-7954
Practice Address - Country:US
Practice Address - Phone:775-870-4334
Practice Address - Fax:775-870-4634
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN000604363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVAPN00490OtherNV STATE PHARMACY NO.
NVAPN000604OtherAPN NURSING LIC
NVAPN00490OtherNV STATE PHARMACY NO.