Provider Demographics
NPI:1528692134
Name:CLUSTER CONSULT PLLC
Entity type:Organization
Organization Name:CLUSTER CONSULT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:REITAN
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:888-212-4243
Mailing Address - Street 1:PO BOX 82
Mailing Address - Street 2:
Mailing Address - City:SHANNON
Mailing Address - State:AL
Mailing Address - Zip Code:35142-0082
Mailing Address - Country:US
Mailing Address - Phone:888-212-4243
Mailing Address - Fax:
Practice Address - Street 1:3502 STIRLING ST
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76310-1760
Practice Address - Country:US
Practice Address - Phone:888-212-4243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty