Provider Demographics
NPI:1518787308
Name:REINBOLD, KIMBERLY M (CSFA)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:M
Last Name:REINBOLD
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9910 GREEN PARK RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-6144
Mailing Address - Country:US
Mailing Address - Phone:314-565-8419
Mailing Address - Fax:
Practice Address - Street 1:1050 OLD DES PERES RD STE 150
Practice Address - Street 2:
Practice Address - City:DES PERES
Practice Address - State:MO
Practice Address - Zip Code:63131-1874
Practice Address - Country:US
Practice Address - Phone:314-569-2918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant