Doctor Name: | PEGGIE L REINHARDT |
NPI Number: | 1417367384 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSN, FNP-BC |
License Number: | COA.15751-NP |
Business Practice Address: | 354 W Main Rd Conneaut, OH - 440302043 |
Business Phone Number: | 4405992262 |
Business Fax Number: | |
Mailing Address: | 354 W Main Rd, CONNEAUT |
State: | OH |
Postal Code: | 440302043 |
Phone Number: | 4405992262 |
Fax Number: | |
NPI Enumeration Date: | 05/01/2014 |
NPI Last Update Date: | 08/06/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | COA.15751-NP |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |