SAGEBRUSH PSYCHIATRY PLLC NPI 1982360137

NPI Information

NPI: 1982360137
Provider Name: SAGEBRUSH PSYCHIATRY, PLLC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

CLIA Number: 29D2293279

Address:
5470 KIETZKE LN STE 300
RENO, NV
ZIP 89511
Phone: (775) 410-0189
Get Directions

SAGEBRUSH PSYCHIATRY, PLLC is a psychiatric/mental health nurse practitioner in Reno, NV. SAGEBRUSH PSYCHIATRY, PLLC NPI is 1982360137. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5470 KIETZKE LN STE 300
RENO, NV
ZIP 89511-099
Phone: (775) 410-0189
Fax: (775) 339-0105

The provider's authorized official is Jeffrey Wright Bayless .
The authorized official title is Founder and has the following contact phone number (512) 436-5841.

The CLIA number assigned to this NPI record is 29D2293279 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/11/2021 and was last updated on 11/3/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	247220	OTHER	ARIZONA	APRN LICENSE
2	187410	OTHER	ALASKA	APRN LICENSE
3	829036	OTHER	NEVADA	APRN LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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