Individual
JOEL GREG MCREYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2810 W 35TH ST, KEARNEY, NE 68845-2909
(308) 865-2570
(308) 865-2508
Mailing address
2810 W 35TH ST, KEARNEY, NE 68845-2909
(308) 865-2570
(308) 865-2508
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
971
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100414240A
KANSAS MEDICAID
KS
01
—
37450
BCBS INDIVIDUAL PROVIDER
NE
05
—
47062901713
—
NE
Enumeration date
09/21/2006
Last updated
07/14/2014
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