Healthcare Provider Details

I. General information

NPI: 1366967945
Provider Name (Legal Business Name): PAULETTE LYNNE REIGHARD ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PAULETTE LYNNE DANGER ARNP

II. Dates (important events)

Enumeration Date: 08/04/2017
Last Update Date: 03/22/2024
Certification Date: 03/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 PLEASANT ST
DES MOINES IA
50309
US

IV. Provider business mailing address

421 VINE AVE
ALBERT LEA MN
56007-4453
US

V. Phone/Fax

Practice location:
  • Phone: 515-241-6212
  • Fax:
Mailing address:
  • Phone: 641-858-6347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number076298
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberA076298
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA076298
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: