Provider Demographics
NPI:1073921433
Name:REIGHARD, WHITNEY
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:REIGHARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2751 BAY PARK DR
Mailing Address - Street 2:SUITE 303
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-4921
Mailing Address - Country:US
Mailing Address - Phone:419-690-7676
Mailing Address - Fax:419-690-7679
Practice Address - Street 1:2751 BAY PARK DR
Practice Address - Street 2:SUITE 303
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-4921
Practice Address - Country:US
Practice Address - Phone:419-690-7676
Practice Address - Fax:419-690-7679
Is Sole Proprietor?:No
Enumeration Date:2014-07-30
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA15980-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily