Provider Demographics
NPI:1669230736
Name:REIMER, ANITA CHRISTINE (RN CCM)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:CHRISTINE
Last Name:REIMER
Suffix:
Gender:F
Credentials:RN CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 N LAKE RIDGE ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-1680
Mailing Address - Country:US
Mailing Address - Phone:316-249-6202
Mailing Address - Fax:
Practice Address - Street 1:2705 N LAKE RIDGE ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-1680
Practice Address - Country:US
Practice Address - Phone:316-249-6202
Practice Address - Fax:877-874-2461
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-43654-092163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management