SHELLY JO REITEN PAC NPI 1114994928

NPI Information

NPI: 1114994928
Provider Name: SHELLY JO REITEN, PAC
Classification: Clinical Nurse Specialist - 364SF0001X
Entity Type: Individual

Specialization: Family Health

PECOS Registration: Yes

Address:
1701 W. CURTIS
CHAMPAIGN, IL
ZIP 61822
Phone: (217) 365-6203
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Shelly Jo Reiten, PAC is a family health clinical nurse specialist in Champaign, IL with 26 years of experience. Shelly Jo Reiten, PAC NPI is 1114994928. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: EMORY UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1998

The provider's business location address is:

1701 W. CURTIS
CHAMPAIGN, IL
ZIP 61822-678
Phone: (217) 365-6203

The NPI 1114994928 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/1/2006 and was last updated on 7/30/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	364SF0001X	Clinical Nurse Specialist	Family Health	085001205	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P96864	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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