Provider Demographics
NPI:1114920873
Name:RINEHART, DIANNE (PA-C)
Entity type:Individual
Prefix:
First Name:DIANNE
Middle Name:
Last Name:RINEHART
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALLTOWN
Mailing Address - State:IA
Mailing Address - Zip Code:50158-1928
Mailing Address - Country:US
Mailing Address - Phone:641-752-4681
Mailing Address - Fax:641-752-6572
Practice Address - Street 1:407 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158-1928
Practice Address - Country:US
Practice Address - Phone:641-752-4681
Practice Address - Fax:641-752-6572
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA#000659363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI9338Medicare ID - Type UnspecifiedMC#
IAP86293Medicare UPIN