Provider Demographics
NPI:1386739803
Name:REINECKE-KASHIMA, TRACEY (CRNP)
Entity type:Individual
Prefix:
First Name:TRACEY
Middle Name:
Last Name:REINECKE-KASHIMA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 CATON AVE
Mailing Address - Street 2:MARYLAND METABOLIC INSTITUTE
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-5201
Mailing Address - Country:US
Mailing Address - Phone:410-368-3228
Mailing Address - Fax:
Practice Address - Street 1:900 CATON AVE
Practice Address - Street 2:MARYLAND METABOLIC INSTITUTE
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-5201
Practice Address - Country:US
Practice Address - Phone:410-368-3228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR124296363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health