Provider Demographics
NPI:1487053930
Name:REINECKE, ASHLEY T (APRN)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:T
Last Name:REINECKE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 COLUMBINE DRIVE
Mailing Address - Street 2:
Mailing Address - City:HOLTON
Mailing Address - State:KS
Mailing Address - Zip Code:66436
Mailing Address - Country:US
Mailing Address - Phone:785-364-2126
Mailing Address - Fax:
Practice Address - Street 1:323 2ND ST.
Practice Address - Street 2:
Practice Address - City:WETMORE
Practice Address - State:KS
Practice Address - Zip Code:66550
Practice Address - Country:US
Practice Address - Phone:785-866-4775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-76456-022363LF0000X
KS53-76456363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily