Individual
GINA MAUREEN REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
5555 GLENDON CT, DUBLIN, OH 43016-3249
(574) 256-7308
(574) 256-7314
Mailing address
PO BOX 1086, MISHAWAKA, IN 46546-1086
(574) 256-7308
(574) 256-7314
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
28111264A
IN
163WR0400X
Rehabilitation Registered Nurse
00019239
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2811264A
INDIANA RN LICENSE
IN
Enumeration date
08/28/2007
Last updated
08/28/2007
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