Individual
AMY REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1 WAHOO AVE, GROTON, CT 06349-2324
(860) 694-2493
Mailing address
PO BOX 600, GROTON, CT 06349-5600
(860) 694-2570
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
1-055560
AL
363LX0106X
Occupational Health Nurse Practitioner
Primary
1-055560
AL
Other
Enumeration date
10/14/2008
Last updated
04/14/2021
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