Healthcare Provider Details

I. General information

NPI: 1770800229
Provider Name (Legal Business Name): DANA LYNN CARLY REEHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2010
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6505 MARKET ST
BOARDMAN OH
44512-3457
US

IV. Provider business mailing address

6505 MARKET ST
BOARDMAN OH
44512-3457
US

V. Phone/Fax

Practice location:
  • Phone: 330-543-3276
  • Fax:
Mailing address:
  • Phone: 330-543-3276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP13105
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP010791
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: