Provider Demographics
NPI:1073302436
Name:IOSE, PETER DELVIN
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:DELVIN
Last Name:IOSE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 BATES AVE
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-2621
Mailing Address - Country:US
Mailing Address - Phone:775-200-3314
Mailing Address - Fax:
Practice Address - Street 1:990 BATES AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-2621
Practice Address - Country:US
Practice Address - Phone:775-200-3314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide