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Individual
KIMBERLY REYNOLDS
Active
Individual
KIMBERLY REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
502136
TX
363LN0000X
Neonatal Nurse Practitioner
Primary
502136
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
096183102
—
TX
05
—
096183103
—
TX
05
—
200061520 A
—
OK
05
—
55522386
—
NM
Enumeration date
07/07/2006
Last updated
06/27/2014
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