Provider Demographics
NPI:1902434418
Name:REITMEIER, JUDY KAY
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:KAY
Last Name:REITMEIER
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 1:335 GREEN JACKET CT
Mailing Address - Street 2:
Mailing Address - City:AVON LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44012-2271
Mailing Address - Country:US
Mailing Address - Phone:314-422-2142
Mailing Address - Fax:
Practice Address - Street 1:335 GREEN JACKET CT
Practice Address - Street 2:
Practice Address - City:AVON LAKE
Practice Address - State:OH
Practice Address - Zip Code:44012-2271
Practice Address - Country:US
Practice Address - Phone:314-422-2142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-30
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide