Individual
CASEY LEE REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
850 W BARAGA AVE, MARQUETTE, MI 49855-4550
(906) 449-1270
Mailing address
850 W BARAGA AVE, MARQUETTE, MI 49855-4550
(906) 449-1270
Taxonomy
Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
4704279943
MI
363LG0600X
Gerontology Nurse Practitioner
4704279943
MI
Other
Enumeration date
05/28/2021
Last updated
10/20/2021
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