MEDICARE: BRENDA REIK

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
1	164W00000X	Licensed Practical Nurse	LPN-37104	MT

General Provider Information

NPI Number	:	1366980120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA REIK

Provider Business Mailing Address
First Line	:	634 GOLD CREEK LOOP
Second Line	:
City	:	HAMILTON
State	:	MT
Zip	:	59840-9742
Country	:	US
Telephone Number	:	406-360-8734
Fax Number	:

Provider Business Practice Location Address
First Line	:	1404 WESTWOOD DR
Second Line	:
City	:	HAMILTON
State	:	MT
Zip	:	59840-2315
Country	:	US
Telephone Number	:	406-532-8990
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2017
Last Update Date	:	02/01/2017

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Directions to “ BRENDA REIK ” Practice Location

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