Individual
MARY BETH REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC, APNP
Contact information
Practice address
1511 RAILROAD AVE, PRENTICE, WI 54556-1155
(715) 428-2521
(715) 428-2522
Mailing address
N292 LAMER DR, OGEMA, WI 54459-8764
(715) 767-5199
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
8691-33
WI
Other
Enumeration date
09/10/2018
Last updated
09/10/2018
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