Provider Demographics
NPI:1700528940
Name:REINHARDT, MARY LYNN (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:LYNN
Last Name:REINHARDT
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CHATEAU GROVE LN
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-1626
Mailing Address - Country:US
Mailing Address - Phone:833-356-0183
Mailing Address - Fax:
Practice Address - Street 1:6 CHATEAU GROVE LN
Practice Address - Street 2:
Practice Address - City:BARBOURSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25504-1626
Practice Address - Country:US
Practice Address - Phone:888-492-5336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-08
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3017606363LF0000X
OHAPRN.CNP.0031306363LF0000X
WV15986363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily