Provider Demographics
NPI:1740345453
Name:DUERINCKX, REINA E (WHCNP)
Entity type:Individual
Prefix:
First Name:REINA
Middle Name:E
Last Name:DUERINCKX
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 N BONNIE BRAE ST
Mailing Address - Street 2:STE 304
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-3748
Mailing Address - Country:US
Mailing Address - Phone:940-503-3601
Mailing Address - Fax:940-503-3602
Practice Address - Street 1:2665 SCRIPTURE STREET
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-3708
Practice Address - Country:US
Practice Address - Phone:940-535-5767
Practice Address - Fax:940-898-0147
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX662345363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP01031793OtherRAILROARD MEDICARE
TXTXB139353Medicare PIN