Doctor Name: | MS. ALICE EIDE-MASON |
NPI Number: | 1336346857 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 52379 |
Business Practice Address: | 1559 Watasheamu Rd Gardnerville, NV - 894607455 |
Business Phone Number: | 7752654215 |
Business Fax Number: | 7752656071 |
Mailing Address: | 1559 Watasheamu Rd, GARDNERVILLE |
State: | NV |
Postal Code: | 894607455 |
Phone Number: | 7752654215 |
Fax Number: | 7752656071 |
NPI Enumeration Date: | 06/28/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WG0000X |
License Number: | 52379 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NV |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | General Practice |
Taxonomy Definition: |