Provider Demographics
NPI:1760931067
Name:REINICKER, YOUA XIONG (RN)
Entity Type:Individual
Prefix:
First Name:YOUA
Middle Name:XIONG
Last Name:REINICKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11004 W MICHIGAN ST
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3708
Mailing Address - Country:US
Mailing Address - Phone:414-331-6809
Mailing Address - Fax:
Practice Address - Street 1:11004 W MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-3708
Practice Address - Country:US
Practice Address - Phone:414-331-6809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-27
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI231064-30163W00000X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health