Healthcare Provider Details

I. General information

NPI: 1356503759
Provider Name (Legal Business Name): SANDRA F REINERS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2008
Last Update Date: 07/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9023 CAMERON ST
DUSON LA
70529
US

IV. Provider business mailing address

PO BOX 370
DUSON LA
70529
US

V. Phone/Fax

Practice location:
  • Phone: 337-873-8244
  • Fax: 337-873-8274
Mailing address:
  • Phone: 337-873-8244
  • Fax: 337-873-8274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP05576
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number1904
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: