Provider Demographics
NPI:1578046173
Name:REINHOLT, ELIZABETH A (CNM)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:REINHOLT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2760 S ELM AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93706-5435
Mailing Address - Country:US
Mailing Address - Phone:595-457-5300
Mailing Address - Fax:
Practice Address - Street 1:2760 S ELM AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93706-5435
Practice Address - Country:US
Practice Address - Phone:559-457-5300
Practice Address - Fax:559-457-5390
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA235961367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife