Individual
TAMARA J REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
909 E STATE BLVD, FORT WAYNE, IN 46805-3404
(260) 481-2700
Mailing address
909 E STATE BLVD, FORT WAYNE, IN 46805-3404
(260) 481-2700
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
71000376
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71000376A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200196310
—
IN
01
—
M900020621
MEDICARE PTAN
IN
Enumeration date
10/11/2006
Last updated
07/16/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us