Healthcare Provider Details

I. General information

NPI: 1477184497
Provider Name (Legal Business Name): HALLE REIMER PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HALLE MILLER PA

II. Dates (important events)

Enumeration Date: 01/29/2020
Last Update Date: 04/04/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 N WALDRON ST
HUTCHINSON KS
67502-1197
US

IV. Provider business mailing address

2101 N WALDRON ST
HUTCHINSON KS
67502-1197
US

V. Phone/Fax

Practice location:
  • Phone: 620-694-4192
  • Fax: 620-694-2128
Mailing address:
  • Phone: 620-669-2500
  • Fax: 620-669-2597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number15-02308
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number15-02308
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: