Provider Demographics
NPI:1932380797
Name:REIGHTER, DAVID TODD (NREMT-P/RN)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:TODD
Last Name:REIGHTER
Suffix:
Gender:M
Credentials:NREMT-P/RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 WILLOW DR
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:IN
Mailing Address - Zip Code:46706-3215
Mailing Address - Country:US
Mailing Address - Phone:260-570-7062
Mailing Address - Fax:
Practice Address - Street 1:1405 WILLOW DR
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:IN
Practice Address - Zip Code:46706-3215
Practice Address - Country:US
Practice Address - Phone:260-570-7062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-21
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1753891146L00000X
P0973771146L00000X
IN28173307A163WE0003X
MI4704262772163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic