Individual
SUSAN MARIE REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
522 N HANCOCK ST, OTTUMWA, IA 52501-4231
(641) 683-0800
(641) 683-0801
Mailing address
1 SAINT JOSEPH DR, CENTERVILLE, IA 52544-9017
(641) 437-3000
(641) 437-3403
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
36832
MT
363LF0000X
Family Nurse Practitioner
Primary
A074307
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000374761
BCBSMT
MT
05
—
1801889498
—
ID
05
—
1801889498
—
MT
05
—
1801889498
—
WA
Enumeration date
08/30/2005
Last updated
03/25/2024
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