Healthcare Provider Details

I. General information

NPI: 1477609717
Provider Name (Legal Business Name): AMY EILEEN REINHARD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S MERIDIAN ST STE 400
INDIANAPOLIS IN
46225-1076
US

IV. Provider business mailing address

647 GAINESWAY CIRCLE RD
VALPARAISO IN
46385-8901
US

V. Phone/Fax

Practice location:
  • Phone: 317-637-4357
  • Fax:
Mailing address:
  • Phone: 219-477-5350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number71001199A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: