Provider Demographics
NPI:1326197559
Name:REIFF, KAREN CHRISTINE (CP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:CHRISTINE
Last Name:REIFF
Suffix:
Gender:F
Credentials:CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2136 KATHRYN DR
Mailing Address - Street 2:
Mailing Address - City:REPUBLIC
Mailing Address - State:MO
Mailing Address - Zip Code:65738-1770
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3230 S NATIONAL AVE
Practice Address - Street 2:SUITE B
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-7303
Practice Address - Country:US
Practice Address - Phone:417-881-8511
Practice Address - Fax:417-881-8823
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CP001726224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
Provider Identifiers
StateIdentifier IDID TypeIssuer
186285OtherBCBS OF MO PROVIDER ID
4694950001Medicare ID - Type Unspecified