Individual
MS. AMY CORINNE REESIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
609 DAFFIN LANE, DENTON, MD 21629-1392
(410) 479-2650
(410) 479-1626
Mailing address
PO BOX 660, 301 RANDOLPH STREET, DENTON, MD 21629-0660
(410) 479-4306
(410) 479-1714
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R133336
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012953
PRIORITY PARTNERS
MD
01
—
521116591
TRICARE
MD
01
—
60958803
CAREFIRST BC/BS RENDERING
MD
01
—
6191265
CIGNA
MD
01
—
737190
NCPPO
MD
05
—
784381000
—
MD
01
—
T5880026
CF BC/BS GRP/GHMSI/BL CHO
MD
Enumeration date
03/01/2006
Last updated
09/04/2009
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