Most Relevant Information
Provider Data
| NPI Number: | 1003578204 |
| Provider Name: | SHAYLEE NYSTROM PA |
| Entity Type: | Individual |
| Taxonomy Code: | 363AM0700X |
| Specialty: | Physician Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/06/2021 |
| Last Updated: | 10/06/2021 |
Provider Practice Location
5578 LONGLEY LN
RENO
NV
895111825
Practice Location Phone/Fax
| Phone: | 7752848650 |
| Fax: |
Provider Mailing Location
5578 LONGLEY LN
RENO
NV
895111825
Provider Mailing Phone/Fax
| Phone: | 7752848650 |
| Fax: |