1184736894 NPI number — MS. RENEE LYNN REISINGER MS CRNP

Table of content: MS. RENEE LYNN REISINGER MS CRNP (NPI 1184736894)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184736894 NPI number — MS. RENEE LYNN REISINGER MS CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REISINGER
Provider First Name:
RENEE
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KAUN
Provider Other First Name:
RENEE
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1184736894
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
330 N HOWARD ST.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-576-1400
Provider Business Mailing Address Fax Number:
410-576-7600

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8579 COMMERCE DRIVE
Provider Second Line Business Practice Location Address:
#102
Provider Business Practice Location Address City Name:
EASTON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-820-9067
Provider Business Practice Location Address Fax Number:
410-820-9674
Provider Enumeration Date:
08/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  R083132 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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