Provider Demographics
NPI:1336510510
Name:REITMEIER, ARLYS
Entity Type:Individual
Prefix:
First Name:ARLYS
Middle Name:
Last Name:REITMEIER
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 1:2554 AUGUSTA DR
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-2825
Mailing Address - Country:US
Mailing Address - Phone:701-772-6981
Mailing Address - Fax:
Practice Address - Street 1:2554 AUGUSTA DR
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-2825
Practice Address - Country:US
Practice Address - Phone:701-772-6981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-13
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR28427163W00000X
MNR 92291-3163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse