Provider Demographics
NPI:1285849208
Name:REISS, LIND S (CFNP)
Entity type:Individual
Prefix:MS
First Name:LIND
Middle Name:S
Last Name:REISS
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11130 STERLING COVE DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23838-5158
Mailing Address - Country:US
Mailing Address - Phone:804-751-9004
Mailing Address - Fax:
Practice Address - Street 1:1108 COURTHOUSE RD STE D
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23236-3197
Practice Address - Country:US
Practice Address - Phone:804-423-5050
Practice Address - Fax:804-423-5048
Is Sole Proprietor?:No
Enumeration Date:2007-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024063173363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily