Provider Demographics
NPI:1902113210
Name:MORTARA, ANN CECELIA (APN)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:CECELIA
Last Name:MORTARA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:CECELIA
Other - Last Name:SNELLGROVE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:645 N ARLINGTON AVE
Mailing Address - Street 2:STE 400
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4451
Mailing Address - Country:US
Mailing Address - Phone:775-329-6241
Mailing Address - Fax:775-329-4921
Practice Address - Street 1:635 INNOVATION DR STE 300
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2215
Practice Address - Country:US
Practice Address - Phone:775-329-6241
Practice Address - Fax:775-329-4921
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN001224363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health