Andresa Carlson
Individual provider Active NPI Anesthesiology Physician · Reno, NV
NPI 1891157590 · NPPES record last updated Oct 6, 2020
Key facts
- NPI
- 1891157590
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 66942 (MN)
- Practice address
- 1155 Mill St
W11
Reno, NV 89502-1576 - Phone
- (775) 327-5174
- Fax
- (775) 327-5178
- NPI assigned
- Mar 22, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 66942 | MN | MD | Anesthesiology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Anesthesiology Physician | 207L00000X | 66942 | MN | Yes |
Addresses
Primary practice location
1155 Mill St
W11
Reno, NV 89502-1576
Mailing address
PO Box 47159
Plymouth, MN 55447-0159
Phone (763) 559-3779
Other providers in Reno, NV
- Ashley Nicole Carl
- Samuel Benjamin Carli
- Yelena V. Carling
- Stephanie Ann Carlsen
- Aleta Diane Carlson
- Carolyn Carlson
- David L. Carlson
- Emily Carlson
- Mary Carlson
- Rita A. Carlson
All providers in Reno, NV · Anesthesiology Physician in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.