Provider Demographics
NPI:1821078353
Name:REISINGER, MICHELE E (ARNP-C)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:E
Last Name:REISINGER
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21055 DONAHOO RD
Mailing Address - Street 2:
Mailing Address - City:HAVENSVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:66432-9665
Mailing Address - Country:US
Mailing Address - Phone:785-948-2070
Mailing Address - Fax:
Practice Address - Street 1:114 W 8TH ST
Practice Address - Street 2:
Practice Address - City:ONAGA
Practice Address - State:KS
Practice Address - Zip Code:66521-9574
Practice Address - Country:US
Practice Address - Phone:785-889-4241
Practice Address - Fax:785-889-4749
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44643363LF0000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100295130BMedicaid
KS160099Medicare PIN