Provider Demographics
NPI:1215134507
Name:REIGERT, JUDITH ANN (NP)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANN
Last Name:REIGERT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2423 W 137TH PL
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66224-4216
Mailing Address - Country:US
Mailing Address - Phone:816-352-6645
Mailing Address - Fax:
Practice Address - Street 1:2423 W 137TH PL
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66224-4216
Practice Address - Country:US
Practice Address - Phone:816-352-6645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT366935-4405363LF0000X
AZRN117988363LF0000X
KS53-75648-122363LF0000X
MO2012017311363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily