MEDICARE: AMY REIST RN

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	363LF0000X	Family Nurse Practitioner	53-84647-012	KS
2	163W00000X	Registered Nurse	13-136230-012	KS

General Provider Information

NPI Number	:	1881582229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY REIST RN

Provider Business Mailing Address
First Line	:	302 FLEMING ST STE 2
Second Line	:
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-6162
Country	:	US
Telephone Number	:	620-271-1424
Fax Number	:

Provider Business Practice Location Address
First Line	:	302 FLEMING ST STE 2
Second Line	:
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-6162
Country	:	US
Telephone Number	:	620-271-1424
Fax Number	:

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

Provider Enumeration Date	:	06/25/2025
Last Update Date	:	11/17/2025

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Directions to “ AMY REIST RN” Practice Location

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