Provider Demographics
NPI:1346093028
Name:REIN, ELIZABETH ANNA (RN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANNA
Last Name:REIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 SEAFOAM AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:MA
Mailing Address - Zip Code:02152-1372
Mailing Address - Country:US
Mailing Address - Phone:315-413-1167
Mailing Address - Fax:
Practice Address - Street 1:21 SEAFOAM AVE APT 3
Practice Address - Street 2:
Practice Address - City:WINTHROP
Practice Address - State:MA
Practice Address - Zip Code:02152-1372
Practice Address - Country:US
Practice Address - Phone:315-413-1167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2391143163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health