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NPI Code Detail

MEDICARE: ERIN REIMAN RN, BSN

MEDICARE:   ERIN  REIMAN  RN, BSN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse169644AZ

General Provider Information

NPI Number : 1356626063
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIN REIMAN RN, BSN
Provider Business Mailing Address
First Line : 2296 OMAHA DR
Second Line :
City : KINGMAN
State : AZ
Zip : 86401-6531
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3404 SANTA MARIA
Second Line : BLACK MOUNTAIN ELEMENTARY
City : GOLDEN VALLEY
State : AZ
Zip : 86413
Country : US
Telephone Number : 928-565-9111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2011
Last Update Date : 10/13/2011

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