Individual
CANDACE G HALVORSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNFA
Contact information
Practice address
5590 KIETZKE LN, RENO, NV 89511-3019
(775) 323-2080
Mailing address
5590 KIETZKE LN, RENO, NV 89511-3019
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
CRNFA997428
NV
163W00000X
Registered Nurse
Primary
RN07149
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A005
TRICARE
NV
01
—
CC3239
BC/BS
NV
Enumeration date
06/26/2006
Last updated
03/22/2018
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