Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 17574 | NV |
N | 2080P0208X | Pediatric Infectious Diseases | MD60019801 | WA |
NPI | 1629238332 |
---|---|
Provider Name | Sara Anne Healy |
First Address | Reno, NV 89502-2055 |
Second Address | Reno, NV 89502-1469 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2008 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
22175110 | CAQH (01) |