Provider Demographics
NPI:1073652145
Name:REINEKE, BARBARA PATTERSON (FNP, APRN)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:PATTERSON
Last Name:REINEKE
Suffix:
Gender:F
Credentials:FNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1371 BROWNING AVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-2601
Mailing Address - Country:US
Mailing Address - Phone:801-582-5236
Mailing Address - Fax:
Practice Address - Street 1:1575 W 7000 S
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84084-3431
Practice Address - Country:US
Practice Address - Phone:801-569-9133
Practice Address - Fax:801-569-9103
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2084264405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily