Provider Demographics
NPI:1851137756
Name:REINHARDT, SANDRA RAE (RN)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:RAE
Last Name:REINHARDT
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 1:13671 HIGHWAY 2 AND 52 W
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:ND
Mailing Address - Zip Code:58722-9639
Mailing Address - Country:US
Mailing Address - Phone:612-508-5708
Mailing Address - Fax:
Practice Address - Street 1:3400 S BROADWAY
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-7420
Practice Address - Country:US
Practice Address - Phone:701-418-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR25813163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse