Organization
BATTLEBORN GERIATRICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE KREK AG-ANCP-BC (APRN/OWNER)
(775) 303-2377
Entity
Organization
Contact information
Practice address
1073 DORTMUNDER DR, SPARKS, NV 89441-5848
(775) 303-2377
Mailing address
1073 DORTMUNDER DR, SPARKS, NV 89441-5848
(775) 303-2377
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
208D00000X
General Practice Physician
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942076291
—
NV
Enumeration date
08/21/2024
Last updated
08/21/2024
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