Provider Demographics
NPI:1396619714
Name:REIFENRATH, SHANNE MARIE
Entity type:Individual
Prefix:
First Name:SHANNE
Middle Name:MARIE
Last Name:REIFENRATH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 PLAZA BLVD APT 18
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-4812
Mailing Address - Country:US
Mailing Address - Phone:308-251-3112
Mailing Address - Fax:
Practice Address - Street 1:50 PLAZA BLVD APT 18
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-4812
Practice Address - Country:US
Practice Address - Phone:308-251-3112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant