Provider Demographics
NPI:1871799148
Name:REICHERT, JANICE (MSN,RN,CRNP)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:REICHERT
Suffix:
Gender:F
Credentials:MSN,RN,CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 N PARK RD
Mailing Address - Street 2:BERKSHIRE PSYCHIATRIC & BEHAVIORAL HEALTH SERVICES, PC
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-2912
Mailing Address - Country:US
Mailing Address - Phone:610-375-0544
Mailing Address - Fax:610-378-9779
Practice Address - Street 1:716 N PARK RD
Practice Address - Street 2:BERKSHIRE PSYCHIATRIC & BEHAVIORAL HEALTH SERVICES, PC
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-2912
Practice Address - Country:US
Practice Address - Phone:610-375-0544
Practice Address - Fax:610-378-9779
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN220508163W00000X
PASP010562363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA172421XTGMedicare PIN
172421Medicare PIN