Individual
MS. MICHELLE D TAVENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
5437 KIETZKE LN, RENO, NV 89511-1088
(775) 322-4550
(755) 322-4956
Mailing address
5437 KIETZKE LN, RENO, NV 89511-1088
(775) 322-4550
(775) 322-4956
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN000957
NV
363LF0000X
Family Nurse Practitioner
APRN000957
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12200330
CAQH
NV
Enumeration date
01/28/2008
Last updated
04/11/2024
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