Individual
BETSY LYNN REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1400 N RITTER AVE STE 340, INDIANAPOLIS, IN 46219-3049
(317) 355-5870
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28167335A
IN
363LF0000X
Family Nurse Practitioner
Primary
71014850A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300085323
—
IN
Enumeration date
11/16/2023
Last updated
01/25/2024
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