Healthcare Provider Details

I. General information

NPI: 1184792046
Provider Name (Legal Business Name): DARLEEN ELIZABETH REINKING RD,LD,CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 10/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HOSPITAL RD
PRINCE FREDERICK MD
20678-4017
US

IV. Provider business mailing address

920 ELKRIDGE LANDING RD
LINTHICUM MD
21090-2917
US

V. Phone/Fax

Practice location:
  • Phone: 301-855-1012
  • Fax: 410-414-4640
Mailing address:
  • Phone: 410-763-8787
  • Fax: 410-763-8788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberD01009
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: