Provider Demographics
NPI:1790130797
Name:REINEMEYER, KATHLEEN ELYSE (APRN)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ELYSE
Last Name:REINEMEYER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:ELYSE
Other - Last Name:MCCULLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2620 ELM HILL PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-3108
Mailing Address - Country:US
Mailing Address - Phone:615-425-4200
Mailing Address - Fax:
Practice Address - Street 1:4925 JACKMAN RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43613-3574
Practice Address - Country:US
Practice Address - Phone:419-473-1715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-27
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.390686-363LF0000X
OHAPRN.CNP.19238363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily