Individual
MALLORY CUSHNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
973 MICA DRIVE, SUITE 201, CARSON CITY, NV 89705-7258
(775) 783-6109
Mailing address
973 MICA DR STE 201, CARSON CITY, NV 89705-7258
(775) 783-6109
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN236296
GA
363L00000X
Nurse Practitioner
Primary
APRN002663
NV
363L00000X
Nurse Practitioner
TAPRN701656
NV
Other
Enumeration date
07/06/2017
Last updated
07/21/2022
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