Individual
JOHN BRADLEY REINKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
10 HOSPITAL DR, SAINT PETERS, MO 63376-1659
(314) 895-3828
(636) 922-5157
Mailing address
PO BOX 5, HAZELWOOD, MO 63042-0005
(314) 895-3828
(636) 922-5157
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
155412
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
916151715
—
MO
01
—
P00165057
RAILROAD MEDICARE
MO
Enumeration date
01/16/2007
Last updated
04/29/2011
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