Provider Demographics
NPI:1386293272
Name:FAUST NICHOLS, CLAIRE MARIE (PA)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:MARIE
Last Name:FAUST NICHOLS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:MARIE
Other - Last Name:FAUST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:299 E PLUMB LN STE 170
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-3475
Mailing Address - Country:US
Mailing Address - Phone:541-520-3334
Mailing Address - Fax:
Practice Address - Street 1:299 E PLUMB LN STE 170
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-3475
Practice Address - Country:US
Practice Address - Phone:541-520-3334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-04
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA2045363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant