Healthcare Provider Details

I. General information

NPI: 1245195593
Provider Name (Legal Business Name): BROOKLYN REINERT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W 16TH ST STE A #1216
YUMA AZ
85364-4734
US

IV. Provider business mailing address

101 W 16TH ST STE A
YUMA AZ
85364-4734
US

V. Phone/Fax

Practice location:
  • Phone: 928-580-6510
  • Fax:
Mailing address:
  • Phone: 928-580-6510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-319095
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: