Provider Demographics
NPI:1255798393
Name:REINHART, JEANA (NP-C)
Entity type:Individual
Prefix:MRS
First Name:JEANA
Middle Name:
Last Name:REINHART
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:JEANA
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 42
Mailing Address - Street 2:239 N 2ND
Mailing Address - City:PORTAGE
Mailing Address - State:OH
Mailing Address - Zip Code:43451
Mailing Address - Country:US
Mailing Address - Phone:419-575-8019
Mailing Address - Fax:
Practice Address - Street 1:14962 SAND RIDGE RD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-9161
Practice Address - Country:US
Practice Address - Phone:419-575-8019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-20
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF1115001363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily