Provider Demographics
NPI:1093704926
Name:REINEKE, BRANDY S (PA)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:S
Last Name:REINEKE
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:8920 FREMONT ST APT 225
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68507-2290
Mailing Address - Country:US
Mailing Address - Phone:402-202-1397
Mailing Address - Fax:
Practice Address - Street 1:6360 JOHN J PERSHING DR FL 2
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68110-1100
Practice Address - Country:US
Practice Address - Phone:402-935-8100
Practice Address - Fax:402-935-8101
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2023-09-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE1226363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE38587OtherBCBS OF NEBRASKA
NE38587OtherBCBS OF NEBRASKA