Individual
MARIE RUTH REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4101 WOOLWORTH AVE, OMAHA, NE 68105-1850
(402) 995-5368
Mailing address
4209 N 91ST ST, OMAHA, NE 68134-4025
(402) 968-3023
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
57940
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57940
NEBRASK NURSING LICENSE
NE
Enumeration date
07/12/2024
Last updated
07/12/2024
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