Reisenauer, Kimberly W
Reisenauer, Kimberly W is an individual health care provider with primary practice located at 325 Broad St Suite 100, Sumter SC 29150-4167. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Reisenauer, Kimberly W can be contacted via phone (803) 773-5227.Contact Information
Primary practice address
325 Broad St Suite 100
Sumter SC 29150-4167
Phone: (803) 773-5227
Fax: (803) 774-5400
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 638 | South Carolina |
Profile Details
| NPI number | 1023149101 |
|---|---|
| LBN Legal business name | Reisenauer, Kimberly W |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 8th, 2007 |
| Last updated | Feb 1st, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023149101 | NPPES |
| South Carolina | MEDICAID | 0109PA |
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