Provider Demographics
NPI:1952593188
Name:REIER, MISTY LEE (STNA)
Entity Type:Individual
Prefix:MRS
First Name:MISTY
Middle Name:LEE
Last Name:REIER
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:MISTY
Other - Middle Name:LEE
Other - Last Name:WILLIAMSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:STNA
Mailing Address - Street 1:309 E GREENE ST
Mailing Address - Street 2:
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356-2468
Mailing Address - Country:US
Mailing Address - Phone:937-418-2451
Mailing Address - Fax:
Practice Address - Street 1:24 N HAMILTON ST
Practice Address - Street 2:
Practice Address - City:MINSTER
Practice Address - State:OH
Practice Address - Zip Code:45865-1117
Practice Address - Country:US
Practice Address - Phone:419-628-2396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-12
Last Update Date:2007-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400560721106376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide