Individual
LINDA T REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
227 HOSPITAL DR, JACKSON, AL 36545-2423
(251) 246-4446
(251) 246-5111
Mailing address
PO BOX 639, 227 HOSPITAL DRIVE, JACKSON, AL 36545-0639
(251) 246-4446
(251) 246-5111
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-021647
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1750393682
NPI GROUP #
AL
05
—
1750393682
—
AL
01
—
1861492837
MEDICAID RURAL HEALTH
AL
05
—
529700760
—
AL
05
—
541003926
—
AL
Enumeration date
07/29/2005
Last updated
02/07/2012
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