Reichert, Mary Jill

Reichert, Mary Jill is an individual health care provider with primary practice located at 1700 Se Hillmoor Dr Suite 200, Port St Lucie FL 34952-7539. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Reichert, Mary Jill can be contacted via phone (772) 335-9600.

Contact Information

Primary practice address
1700 Se Hillmoor Dr Suite 200 Port St Lucie FL 34952-7539
Phone: (772) 335-9600
Fax: (772) 398-7951
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP3144302 Florida

Profile Details

NPI number 1114140860
LBN Legal business name Reichert, Mary Jill
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 11th, 2007
Last updated Aug 20th, 2009 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114140860 NPPES
Florida MEDICAID 3089614000

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