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Individual

SHAN EDWARD NICKERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
REGISTERED NURSE

Contact information

Practice address
1201 CORPORATE BLVD, RENO, NV 89502-7177
(775) 786-7200
Mailing address
2030 HARMONY VALLEY WAY, RENO, NV 89521-4522
(530) 366-6650

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
864820
NV

Other

Enumeration date
10/31/2023
Last updated
10/31/2023
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