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General NPI Number Information
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NPI Number | 1861700825
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Entity Type | Individual
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Provider Name | ROBERT LAWRENCE REINHARDT RN
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Gender | Male
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Dates
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Enumeration Date | 09/23/2010
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Last Update Date | 09/23/2010
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Provider Practice Location Address
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Address Line | 2307 LAPORTE AVE
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City | VALPARAISO
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State | IN
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Zip | 46383-6996
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Country | US
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Telephone | 219-476-9389
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Fax | 219-476-9432
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Provider Business Mailing Address
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Address Line | PO BOX 2402
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City | VALPARAISO
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State | IN
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Zip | 46384-2402
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Country | US
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Telephone | 219-477-9407
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28150110A
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License Number State | IN
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