Individual
STACEY MAREE REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
4701 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87109-1219
(505) 727-6853
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
(505) 272-1476
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
61339
NM
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
61339
NM
Other
Enumeration date
12/31/2020
Last updated
05/22/2025
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