Individual
MRS. LORA DIANE REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
16000 JOHNSTON MEMORIAL DR, SUITE 313, ABINGDON, VA 24211-7659
(276) 258-3780
(276) 258-3776
Mailing address
16000 JOHNSTON MEMORIAL DR, SUITE 313, ABINGDON, VA 24211-7659
(276) 258-3780
(276) 258-3776
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024171491
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063838654
—
VA
01
—
P01502220
RAILROAD MEDICARE
VA
Enumeration date
03/06/2014
Last updated
02/22/2017
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