Provider Demographics
NPI:1063950814
Name:CIMINSKI, ROBERT LEE JR (RN)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:LEE
Last Name:CIMINSKI
Suffix:JR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1665 OLD HOT SPRINGS RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-0782
Mailing Address - Country:US
Mailing Address - Phone:775-687-0886
Mailing Address - Fax:778-687-1180
Practice Address - Street 1:1665 OLD HOT SPRINGS RD
Practice Address - Street 2:SUITE 150
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-0782
Practice Address - Country:US
Practice Address - Phone:775-687-0886
Practice Address - Fax:778-687-1180
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-01
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN75951261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)