Individual
MRS. JODY L REIFENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085002183
IL
364SF0001X
Family Health Clinical Nurse Specialist
Primary
22669
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085002183
—
IL
Enumeration date
09/17/2006
Last updated
02/26/2015
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