Individual
KINSEY REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PA-C
Contact information
Practice address
379 N 500 W, VERNAL, UT 84078-1956
(435) 789-1165
Mailing address
3206 S 500 E, VERNAL, UT 84078-8821
(435) 790-3809
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11111494-1206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11111494-1206
STATE OF UTAH ACTIVE LICENSE NUMBER
UT
Enumeration date
01/19/2019
Last updated
11/20/2019
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