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General NPI Number Information
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NPI Number | 1952265738
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Entity Type | Individual
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Provider Name | JODIE LYNN REINER PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/15/2025
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 955 W 3300 S
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City | SOUTH SALT LAKE
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State | UT
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Zip | 84119-3325
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Country | US
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Telephone | 801-583-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 7611 S UNION PARK AVE APT C104
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City | SANDY
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State | UT
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Zip | 84047-3028
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Country | US
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Telephone | 530-919-4384
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 12075018-4405
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License Number State | UT
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