Provider Demographics
NPI:1356503759
Name:REINERS, SANDRA F (NP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:F
Last Name:REINERS
Suffix:
Gender:F
Credentials:NP
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 370
Mailing Address - Street 2:
Mailing Address - City:DUSON
Mailing Address - State:LA
Mailing Address - Zip Code:70529
Mailing Address - Country:US
Mailing Address - Phone:337-873-8244
Mailing Address - Fax:337-873-8274
Practice Address - Street 1:9023 CAMERON ST
Practice Address - Street 2:
Practice Address - City:DUSON
Practice Address - State:LA
Practice Address - Zip Code:70529
Practice Address - Country:US
Practice Address - Phone:337-873-8244
Practice Address - Fax:337-873-8274
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1904164W00000X
LAAP05576363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1324256Medicaid
LA1324256Medicaid