Individual
JULIE ANN LISA REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP-BC
Contact information
Practice address
5337 W GRANDE MARKET DR, APPLETON, WI 54913-8442
(920) 731-7445
Mailing address
5337 W GRANDE MARKET DR, APPLETON, WI 54913-8442
(920) 731-7445
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
135242-30
WI
363L00000X
Nurse Practitioner
7843-33
WI
363LF0000X
Family Nurse Practitioner
Primary
7843
WI
Other
Enumeration date
03/16/2011
Last updated
05/01/2019
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