Healthcare Provider Details

I. General information

NPI: 1487053930
Provider Name (Legal Business Name): ASHLEY T REINECKE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2014
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 2ND ST.
WETMORE KS
66550
US

IV. Provider business mailing address

1100 COLUMBINE DRIVE
HOLTON KS
66436
US

V. Phone/Fax

Practice location:
  • Phone: 785-866-4775
  • Fax:
Mailing address:
  • Phone: 785-364-2126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-76456-022
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-76456
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: