Provider Demographics
NPI:1306296322
Name:REICH, AUBREE LYNNE (NP)
Entity type:Individual
Prefix:
First Name:AUBREE
Middle Name:LYNNE
Last Name:REICH
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 1:5980 STATE RD. 38 E
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:IN
Mailing Address - Zip Code:47941-1111
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5980 STATE RD. 38 E
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:IN
Practice Address - Zip Code:47941-0000
Practice Address - Country:US
Practice Address - Phone:765-588-5667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71006280A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN71006280AMedicaid
IN71006280AMedicare PIN
IN71006280AMedicaid
IN71006280AMedicare Oscar/Certification