Individual
MRS. SAMANTHA JENAE REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2045 S. VINEYARD, BLDG N3, SUITE 144, MESA, AZ 85210
(480) 967-6888
(480) 967-6887
Mailing address
2919 S. ELLSWORTH RD., SUITE 135, MESA, AZ 85212-2164
(480) 967-6888
(480) 967-6887
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
238475
AZ
363LF0000X
Family Nurse Practitioner
238475
AZ
Other
Enumeration date
03/01/2020
Last updated
06/03/2021
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