Provider Demographics
NPI:1518426162
Name:REICHERT, RENEE ELIZABETH (APRN MSN PMHNP BC)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:ELIZABETH
Last Name:REICHERT
Suffix:
Gender:F
Credentials:APRN MSN PMHNP BC
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Mailing Address - Street 1:2705 HIGHWAY 51 S
Mailing Address - Street 2:
Mailing Address - City:HERNANDO
Mailing Address - State:MS
Mailing Address - Zip Code:38632-2634
Mailing Address - Country:US
Mailing Address - Phone:662-429-1260
Mailing Address - Fax:662-429-1262
Practice Address - Street 1:5627 GETWELL ROAD
Practice Address - Street 2:BUILDING C SUITE 2
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38672
Practice Address - Country:US
Practice Address - Phone:662-483-1114
Practice Address - Fax:662-314-9689
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-13
Last Update Date:2022-07-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS9040562084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry