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Individual

TERESA L REYNOLDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
119 RIVER DR, PIKEVILLE, KY 41501-1685
(606) 437-5500
Mailing address
119 RIVER DR, PIKEVILLE, KY 41501-1685
(606) 437-5500

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1070865
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
20098091
KY
Enumeration date
06/02/2009
Last updated
06/02/2009
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