Provider Demographics
NPI:1992246474
Name:NESMITH, BRIEAUNA
Entity type:Individual
Prefix:
First Name:BRIEAUNA
Middle Name:
Last Name:NESMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 RENO AVE
Mailing Address - Street 2:APT B
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-2093
Mailing Address - Country:US
Mailing Address - Phone:702-265-7932
Mailing Address - Fax:
Practice Address - Street 1:415 HWY 95 A
Practice Address - Street 2:SUITE 702 G
Practice Address - City:FERNLEY
Practice Address - State:NV
Practice Address - Zip Code:89408
Practice Address - Country:US
Practice Address - Phone:775-575-2284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1710360714Medicaid