Individual
RASHELLE ANNALEE REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
801 POLE LINE RD W, TWIN FALLS, ID 83301-5810
(208) 814-2400
(208) 733-9463
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-8752
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN747079
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
2161871
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN747079
PA RN LICENSE
PA
Enumeration date
02/07/2023
Last updated
08/26/2024
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