Individual
SHELLEY L REICHMUTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8303 DODGE ST, SUITE 225, OMAHA, NE 68114-4108
(402) 354-5860
(402) 354-2350
Mailing address
8303 DODGE ST, SUITE 225, OMAHA, NE 68114-4108
(402) 354-5860
(402) 354-2350
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1314
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00872962
RAILROAD MEDICARE
NE
Enumeration date
06/04/2006
Last updated
08/01/2013
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