Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 10572 | NV |
N | 207PE0004X | Emergency Medical Services | 10572 | NV |
NPI | 1033178249 |
---|---|
Provider Name | Thea Berning |
First Address | Reno, NV 89502-1304 |
Second Address | Reno, NV 89502-1576 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2006 |
Last Update Date | 21/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100501176 | (05) | NV |
100501177 | (05) | NV |
220480 | NEVADACARE (01) | NV |
CC5960 | BCBS (01) | NV |
H98099 | (02) | NV |
P00081755 | RAILROAD MEDICARE (01) | NV |