Basic Information
Provider Information
NPI: 1619546017
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OBREGON
FirstName: CHRISTINE
MiddleName: ANN
NamePrefix:  
NameSuffix:  
Credential: APRN STUDENT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1155 MILL ST MS M14
Address2:  
City: RENO
State: NV
PostalCode: 895021576
CountryCode: US
TelephoneNumber: 7759825262
FaxNumber: 7759824196
Practice Location
Address1: 1155 MILL ST MS W14
Address2:  
City: RENO
State: NV
PostalCode: 895021576
CountryCode: US
TelephoneNumber: 7759827878
FaxNumber: 7759824196
Other Information
ProviderEnumerationDate: 06/21/2021
LastUpdateDate: 06/24/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/24/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN57157NVN Nursing Service ProvidersRegistered Nurse 
363LA2200X842495NVN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
363LG0600X842495NVN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
363LA2100X842495NVY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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