Basic Information
Provider Information
NPI: 1588029979
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAVEZ
FirstName: REBECCA
MiddleName:  
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Credential: MSN, APRN
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Mailing Information
Address1: 1155 MILL ST # MCM14
Address2:  
City: RENO
State: NV
PostalCode: 895021576
CountryCode: US
TelephoneNumber: 7759825262
FaxNumber: 7759823901
Practice Location
Address1: 975 RYLAND ST
Address2: SUITE 105
City: RENO
State: NV
PostalCode: 895021667
CountryCode: US
TelephoneNumber: 7759825640
FaxNumber: 7759825641
Other Information
ProviderEnumerationDate: 12/29/2015
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
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AuthorizedOfficialCredential:  
NPICertificationDate: 07/21/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367A00000XAPRN002106NVN Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 
363LW0102XAPRN002106NVY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health

No ID Information.


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