Provider Demographics
NPI:1851640908
Name:REIKEN, MICHELLE F (MICHELLE REIKEN)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:F
Last Name:REIKEN
Suffix:
Gender:F
Credentials:MICHELLE REIKEN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5205 GREENWOOD AVE
Mailing Address - Street 2:110
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2400
Mailing Address - Country:US
Mailing Address - Phone:561-803-8885
Mailing Address - Fax:
Practice Address - Street 1:5205 GREENWOOD AVE
Practice Address - Street 2:110
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2400
Practice Address - Country:US
Practice Address - Phone:561-803-8885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2729732363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily