Individual
KATHRYN REISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6316 W UNION HILLS DR # 100, GLENDALE, AZ 85308-1001
(623) 233-1318
(623) 233-1313
Mailing address
6316 W UNION HILLS DR # 100, GLENDALE, AZ 85308-1001
(623) 233-1318
(623) 233-1313
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
59691
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005339
—
AZ
01
—
59691
LICENSE
AZ
Enumeration date
03/27/2016
Last updated
08/21/2020
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