Provider Demographics
NPI:1053901496
Name:REINERT, SAMANTHA HAILEY
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:HAILEY
Last Name:REINERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 FLOYD LN
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:GA
Mailing Address - Zip Code:30228-2493
Mailing Address - Country:US
Mailing Address - Phone:678-544-0935
Mailing Address - Fax:
Practice Address - Street 1:170 FLOYD LN
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:GA
Practice Address - Zip Code:30228-2493
Practice Address - Country:US
Practice Address - Phone:678-544-0935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program