Provider Demographics
NPI:1922440320
Name:REINEMEYER, REBEKAH RUSS (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:REBEKAH
Middle Name:RUSS
Last Name:REINEMEYER
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5021 CRAIG RATH BLVD
Mailing Address - Street 2:BLDG 4
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-6243
Mailing Address - Country:US
Mailing Address - Phone:804-592-5437
Mailing Address - Fax:
Practice Address - Street 1:5021 CRAIG RATH BLVD
Practice Address - Street 2:BLDG 4
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-6243
Practice Address - Country:US
Practice Address - Phone:804-592-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024170787363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics