Provider Demographics
NPI:1598092157
Name:REICKS, DONNA MAE (MIDWIFE)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:MAE
Last Name:REICKS
Suffix:
Gender:F
Credentials:MIDWIFE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 2ND ST E
Mailing Address - Street 2:
Mailing Address - City:CRESCO
Mailing Address - State:IA
Mailing Address - Zip Code:52136-1121
Mailing Address - Country:US
Mailing Address - Phone:641-220-5135
Mailing Address - Fax:563-203-9149
Practice Address - Street 1:615 2ND ST E
Practice Address - Street 2:
Practice Address - City:CRESCO
Practice Address - State:IA
Practice Address - Zip Code:52136-1121
Practice Address - Country:US
Practice Address - Phone:641-220-5135
Practice Address - Fax:563-203-9149
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-03
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay