Individual
ELISA REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
3501 PALMER DR STE 201, CAMERON PARK, CA 95682-8276
(530) 672-7040
Mailing address
602 KORU ST, SOUTH LAKE TAHOE, CA 96150-5316
(530) 414-1564
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95036332
CA
Other
Enumeration date
07/24/2025
Last updated
07/24/2025
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