Basic Information
| Provider Information | |||||||||
| NPI: | 1205124401 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RACKER | ||||||||
| FirstName: | NICHOLAS | ||||||||
| MiddleName: | S. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 E LIBERTY ST STE 555 | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895012110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753481900 | ||||||||
| FaxNumber: | 7753481912 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 E LIBERTY ST STE 555 | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895012110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753481900 | ||||||||
| FaxNumber: | 7753481912 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2011 | ||||||||
| LastUpdateDate: | 05/08/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | DO1946 | NV | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.