Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 8842 | NV |
NPI | 1003241712 |
---|---|
Provider Name | Julie Elise Xeras |
First Address | Reno, NV 89502-0845 |
Second Address | Reno, NV 89503-2745 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2013 |
Last Update Date | 12/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G50968 | (02) |