Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | SP021767 | PA |
NPI | 1023647401 |
---|---|
Provider Name | Casey Reiber |
First Address | Toledo, OH 43604-2615 |
Second Address | Pittsburgh, PA 15237-2114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2020 |
Last Update Date | 07/04/2020 |