# LAEL JO REYNOLDS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1689332769
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WP1700X | Perinatal Registered Nurse | N-30935 | ID | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 71578 | ID | Yes |

## Other

- **Enumeration date:** 12/06/2021
- **Last updated:** 07/08/2026