| Full Name | |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 890 Mill St, Reno, Nevada |
| Authorized Official Name and Position | Elissa J. Palmer (PRESIDENT) |
| Authorized Official Contact | 7029926888 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 29506 Las Vegas NV 89126-9506 Ph: (702) 968-4371 | 890 Mill St 102 Reno NV 89502-1442 Ph: (775) 322-2731 |
| NPI Number | 1821121310 |
|---|---|
| Provider Enumeration Date | 03/13/2007 |
| Last Update Date | 10/14/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821121310 | NPI | - | NPPES |
| 2416097 | Medicaid | NV | |
| 100500484 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 000640 (Nevada) | Secondary |
| 363L00000X | Nurse Practitioner | 000640 (Nevada) | Primary |
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