Provider Demographics
NPI:1932668308
Name:SIERRA FRONTIER ADVANCED PRACTICE PC
Entity type:Organization
Organization Name:SIERRA FRONTIER ADVANCED PRACTICE PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:BETHNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIFERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-240-5532
Mailing Address - Street 1:PO BOX 2983
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89432-2983
Mailing Address - Country:US
Mailing Address - Phone:775-240-5532
Mailing Address - Fax:
Practice Address - Street 1:639 ISBELL RD STE 380
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-4982
Practice Address - Country:US
Practice Address - Phone:775-440-1520
Practice Address - Fax:775-451-1870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-15
Last Update Date:2022-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty