Provider Demographics
NPI:1811217078
Name:REINHART, LINDSEY GAIL (PA)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:GAIL
Last Name:REINHART
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 648
Mailing Address - Street 2:
Mailing Address - City:PRINEVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97754-0648
Mailing Address - Country:US
Mailing Address - Phone:541-362-8688
Mailing Address - Fax:
Practice Address - Street 1:198 NE COMBS FLAT RD STE 110
Practice Address - Street 2:
Practice Address - City:PRINEVILLE
Practice Address - State:OR
Practice Address - Zip Code:97754-2563
Practice Address - Country:US
Practice Address - Phone:541-362-8688
Practice Address - Fax:541-550-7779
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-10
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA151672207Q00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR213187Medicaid