Provider Demographics
NPI:1932489994
Name:RHINEHART, LEANN THIELE (NP-C)
Entity Type:Individual
Prefix:
First Name:LEANN
Middle Name:THIELE
Last Name:RHINEHART
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:LEANN
Other - Middle Name:THIELE
Other - Last Name:KANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 S CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62565-1838
Mailing Address - Country:US
Mailing Address - Phone:217-774-4400
Mailing Address - Fax:217-774-6445
Practice Address - Street 1:200 S CEDAR ST
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62565-1838
Practice Address - Country:US
Practice Address - Phone:217-774-4400
Practice Address - Fax:217-774-6445
Is Sole Proprietor?:No
Enumeration Date:2011-08-23
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209009011363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL041255407OtherRN LICENSE NUMBER
IL209009011OtherADVANCED PRACTITIONER LICENSE NUMBER