Provider Demographics
NPI:1295938934
Name:REIGHARD, JOSEPH ADAM (FNP-C, PMHNP-C)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ADAM
Last Name:REIGHARD
Suffix:
Gender:M
Credentials:FNP-C, PMHNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2135 E INDEPENDENCE ST
Mailing Address - Street 2:PMB 1093
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-3749
Mailing Address - Country:US
Mailing Address - Phone:417-830-9266
Mailing Address - Fax:417-900-2992
Practice Address - Street 1:3322 S CAMPBELL AVE STE T-1
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-4980
Practice Address - Country:US
Practice Address - Phone:417-220-4482
Practice Address - Fax:417-414-0017
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016002363163W00000X
MO2023020987363LP0808X
MO2019003456363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420066599Medicaid
MO500128969Medicaid