Individual
DIXIE LEAH REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
202 N DIVISION ST STE 202, AUBURN, WA 98001-4939
(253) 876-8088
Mailing address
202 N DIVISION ST STE 202, AUBURN, WA 98001-4939
(253) 876-8088
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP60448863
WA
363LP0200X
Pediatric Nurse Practitioner
Primary
AP60448863
WA
363LP0200X
Pediatric Nurse Practitioner
ARNP9219864
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005850200
—
FL
01
—
Y0AW9
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/29/2012
Last updated
06/18/2014
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