Provider Demographics
NPI:1982360137
Name:SAGEBRUSH PSYCHIATRY, PLLC
Entity Type:Organization
Organization Name:SAGEBRUSH PSYCHIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:WRIGHT
Authorized Official - Last Name:BAYLESS
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:512-436-5841
Mailing Address - Street 1:11885 CLAIM STAKE DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89506-7540
Mailing Address - Country:US
Mailing Address - Phone:512-436-5841
Mailing Address - Fax:775-339-0105
Practice Address - Street 1:5470 KIETZKE LN STE 300
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2099
Practice Address - Country:US
Practice Address - Phone:775-410-0189
Practice Address - Fax:775-339-0105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-11
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ247220OtherAPRN LICENSE
AK187410OtherAPRN LICENSE
NV829036OtherAPRN LICENSE