Healthcare Provider Details

I. General information

NPI: 1629471081
Provider Name (Legal Business Name): SCOTT REIFSCHNEIDER PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2014
Last Update Date: 09/09/2022
Certification Date: 09/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1113 SHERMAN ST
SAINT PAUL NE
68873-1546
US

IV. Provider business mailing address

PO BOX 406
SAINT PAUL NE
68873-0406
US

V. Phone/Fax

Practice location:
  • Phone: 308-754-4421
  • Fax:
Mailing address:
  • Phone: 308-754-4421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: