1023093143 NPI number — MRS. HEATHER NICOLE REINEMANN OTR

Table of content: MRS. HEATHER NICOLE REINEMANN OTR (NPI 1023093143)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023093143 NPI number — MRS. HEATHER NICOLE REINEMANN OTR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REINEMANN
Provider First Name:
HEATHER
Provider Middle Name:
NICOLE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
OTR
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BLEIER
Provider Other First Name:
HEATHER
Provider Other Middle Name:
NICOLE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
OTR
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1023093143
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2415 WEDEMEYER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHEBOYGAN
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53081
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
920-973-5409
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2021 S ALVERNO RD
Provider Second Line Business Practice Location Address:
MANITOWOC HEALTH & REHAB CENTER
Provider Business Practice Location Address City Name:
MANITOWOC
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54220-9208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
920-683-4592
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/13/2005

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: 225X00000X , with the licence number:  OTH-009223 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225X00000X , with the licence number: 3905 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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