Provider Demographics
NPI:1548306582
Name:VANEPPS, LEE A (MD)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:A
Last Name:VANEPPS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1155 MILL ST MS M14
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1576
Mailing Address - Country:US
Mailing Address - Phone:775-982-5262
Mailing Address - Fax:775-982-4196
Practice Address - Street 1:6570 S MCCARRAN BLVD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6112
Practice Address - Country:US
Practice Address - Phone:775-982-8256
Practice Address - Fax:775-982-8251
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV5904207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1548306582Medicaid
11042101OtherCAQH
NVNV0121OtherBCBS PROVIDER #
NV110238210OtherRAILROAD MEDICARE #
NV32928Medicare ID - Type UnspecifiedPROVIDER NUMBER