Jennifer Marie Reiss Gangnier, PA-C
Dermatology in Brighton, MI. Individual provider (NPI-1).
NPI number1265635155
StatusActive
Last updated in NPPESApr 8, 2016
Details
- NPI
- 1265635155
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Jennifer Marie Reiss Gangnier
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 7, 2007
- Last updated
- Apr 8, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | 5601005019 | MI | Yes |
Other names
- Jennifer Marie Reiss (Former Name)
Practice location
2305 Genoa Business Park DrSuite 180
Brighton, MI 48114-7004
Phone 810-355-4300 · Fax 810-355-4967
Mailing address
43151 Dalcoma DrSuite 5
Clinton Township, MI 48038-6306
Phone 586-286-8720 · Fax 866-790-6803
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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