Provider Demographics
NPI:1417978511
Name:RINEHART, NICHOLE RENEE (DC)
Entity Type:Individual
Prefix:DR
First Name:NICHOLE
Middle Name:RENEE
Last Name:RINEHART
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50125-3703
Mailing Address - Country:US
Mailing Address - Phone:515-962-2015
Mailing Address - Fax:515-962-2015
Practice Address - Street 1:1517 N 1ST ST
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:IA
Practice Address - Zip Code:50125-3703
Practice Address - Country:US
Practice Address - Phone:515-962-2015
Practice Address - Fax:515-962-9093
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06808111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA06238OtherWELLMARK NPP
IAVO9952Medicare UPIN