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:
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Health care specialties

SpecialtyCodeLicense #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 12 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 1023149101 NPPES
South Carolina MEDICAID 0109PA

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