1639528391 NPI number — WEAVER ANESTHESIA SPECIALISTS OF RENO PLLC

Table of content: KALEIGH ANNE WILL APRN (NPI 1366190985)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639528391 NPI number — WEAVER ANESTHESIA SPECIALISTS OF RENO PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WEAVER ANESTHESIA SPECIALISTS OF RENO PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639528391
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/03/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1226
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VERDI
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89439-1226
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-944-8542
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
95 RIVERDALE CIRCLE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VERDI
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89439
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-944-8542
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/03/2016

Additional Information

Authorized Official

Authorized Official Last Name:
WEAVER
Authorized Official First Name:
JEFFREY
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
518-944-8542

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  14649 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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