Individual
MICKIE R REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
506 WINGFIELD ST, RUIDOSO, NM 88345-9327
(505) 257-4577
Mailing address
506 WINGFIELD ST, RUIDOSO, NM 88345-9327
(505) 257-4577
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
3271
NM
Other
Enumeration date
02/25/2009
Last updated
03/24/2009
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