Provider Demographics
NPI:1558188615
Name:REICHELDERFER, RENEE (RN)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:REICHELDERFER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AUDIE MURPHY VA HOSPITAL
Mailing Address - Street 2:7400 MERTON MINTER SUITE E718
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229
Mailing Address - Country:US
Mailing Address - Phone:210-975-2621
Mailing Address - Fax:210-443-0330
Practice Address - Street 1:AUDIE MURPHY VA HOSPITAL
Practice Address - Street 2:7400 MERTON MINTER SUITE E718
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229
Practice Address - Country:US
Practice Address - Phone:210-975-2621
Practice Address - Fax:210-443-0330
Is Sole Proprietor?:No
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX643151163WC0400X
TX00094199171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No163WC0400XNursing Service ProvidersRegistered NurseCase Management