Basic Information
Provider Information
NPI: 1568440212
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: REINECK
FirstName: JOY
MiddleName: C
NamePrefix:  
NameSuffix:  
Credential: C.N.M.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1701 W CHARLESTON BLVD
Address2: #215
City: LAS VEGAS
State: NV
PostalCode: 891022325
CountryCode: US
TelephoneNumber: 7026712395
FaxNumber: 7023825388
Practice Location
Address1: 2231 W CHARLESTON BLVD
Address2: 2ND FLR, UNIVERSITY WOMEN'S CENTER CLINIC
City: LAS VEGAS
State: NV
PostalCode: 891022254
CountryCode: US
TelephoneNumber: 7023832403
FaxNumber: 7026712333
Other Information
ProviderEnumerationDate: 01/04/2006
LastUpdateDate: 09/19/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367A00000XAPN000738NVY Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 

ID Information
IDTypeStateIssuerDescription
CS1206301NVPHARMACY/CDSOTHER
MR035883101NVDEAOTHER


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