Provider Demographics
NPI:1821758160
Name:REINHART, DANA MARIE (RN BSN CCM TNCM)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:MARIE
Last Name:REINHART
Suffix:
Gender:F
Credentials:RN BSN CCM TNCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1391 NW 136TH AVE
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2800
Mailing Address - Country:US
Mailing Address - Phone:931-982-5788
Mailing Address - Fax:
Practice Address - Street 1:1391 NW 136TH AVE
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-2800
Practice Address - Country:US
Practice Address - Phone:931-982-5788
Practice Address - Fax:770-723-8763
Is Sole Proprietor?:No
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNC0004254163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNC00004254OtherCASE MANAGER