Provider Demographics
NPI:1326353681
Name:REITZ, ROBIN A (APRN)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:A
Last Name:REITZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1832
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-1832
Mailing Address - Country:US
Mailing Address - Phone:620-231-1960
Mailing Address - Fax:
Practice Address - Street 1:2100 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:PARSONS
Practice Address - State:KS
Practice Address - Zip Code:67357-4951
Practice Address - Country:US
Practice Address - Phone:620-717-4450
Practice Address - Fax:620-717-4540
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS75229363LP0808X, 363LP0808X
KSTMP141424363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200567420AMedicaid
MO426619409Medicaid
KS200672290DMedicaid
KS110931173OtherMEDICARE