Individual
MR. BOBBY DEAN REYNOLDS II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1503 W ELK AVE, ELIZABETHTON, TN 37643-2876
(423) 543-6660
(423) 543-5133
Mailing address
1503 W ELK AVE, ELIZABETHTON, TN 37643-2876
(423) 543-6660
(423) 543-5133
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN0000007649
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1509464
MEDICARE
TN
05
—
1509464
—
TN
01
—
4330448
BLUE CROSS BLUE SHIELD
TN
Enumeration date
08/18/2006
Last updated
01/04/2013
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