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Individual

CHARLENE REYNOLDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1636 SHADOWOOD LN STE 106, JACKSONVILLE, FL 32207-2187
(904) 695-0249
(904) 695-7385
Mailing address
1636 SHADOWOOD LN STE 106, JACKSONVILLE, FL 32207-2187

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041431448
IL
163W00000X
Registered Nurse
RN9423089
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
209022748
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11009388
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
108934400
FL
Enumeration date
01/06/2020
Last updated
03/12/2025
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