Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 20615 | NV |
N | 207Q00000X | Family Doctor | 53977-20 | WI |
N | 207QS0010X | Family Doctor - Sports Medicine | 20615 | NV |
N | 207QS0010X | Family Doctor - Sports Medicine | 53977 | WI |
NPI | 1295066082 |
---|---|
Provider Name | Cristin E. Newkirk-Thompson |
First Address | Reno, NV 89502-1576 |
Second Address | Reno, NV 89511-8930 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2010 |
Last Update Date | 15/01/2021 |