Provider Demographics
NPI:1619273752
Name:REANO, LAURA (ACNP-BC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:REANO
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:FLEIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4232 FOREST RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45424-4484
Mailing Address - Country:US
Mailing Address - Phone:937-235-5323
Mailing Address - Fax:
Practice Address - Street 1:1 WYOMING ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2722
Practice Address - Country:US
Practice Address - Phone:937-208-4361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN191104363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care