Provider Demographics
NPI:1972688406
Name:REITMAN, KATHE LYNN (PMHNP, BC)
Entity type:Individual
Prefix:MS
First Name:KATHE
Middle Name:LYNN
Last Name:REITMAN
Suffix:
Gender:F
Credentials:PMHNP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6619 N SCOTTSDALE RD STE 23
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-4421
Mailing Address - Country:US
Mailing Address - Phone:802-962-0584
Mailing Address - Fax:480-676-2809
Practice Address - Street 1:6619 N SCOTTSDALE RD STE 23
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85250-4421
Practice Address - Country:US
Practice Address - Phone:623-399-8606
Practice Address - Fax:408-905-8851
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN032996363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZS52378TMedicare UPIN
AZZ21509Medicare PIN