Provider Demographics
NPI:1750002309
Name:REINHARDT, HEATHER R (FNP-BC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:R
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 1:120 KINGS WAY STE 2550
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-2554
Mailing Address - Country:US
Mailing Address - Phone:757-345-2600
Mailing Address - Fax:
Practice Address - Street 1:120 KINGS WAY STE 2550
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-2554
Practice Address - Country:US
Practice Address - Phone:757-345-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-12
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024185009363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner