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Individual

KATHY L REYNOLDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
9701856
NC
2080P0203X
Pediatric Critical Care Medicine Physician
11712
NV
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
4743
SD
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
38372
CO
2080P0214X
Pediatric Pulmonology Physician
4743
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002019725
NV
05
063407700
MN
05
64900789
CO
05
6700510
SD
05
891113P
NC
Enumeration date
05/04/2006
Last updated
11/13/2008
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