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Individual

ERIKA L. REYNOLDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.-C.

Contact information

Practice address
740 S LIMESTONE, SUITE 401, LEXINGTON, KY 40536-0284
(859) 218-3084
(859) 257-2816
Mailing address
740 S LIMESTONE, SUITE 401, LEXINGTON, KY 40536-0284
(859) 218-3084
(859) 257-2816

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA596
KY
363AM0700X
Medical Physician Assistant
PA596
KY
363AS0400X
Surgical Physician Assistant
PA596
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
37903705
MEDICAID LAB GROUP
KY
01
4000501
MEDICARE LAB GROUP
KY
05
95001616
KY
01
970020921
RR MEDICARE PIN
KY
01
CB5773
RR MEDICARE GROUP
KY
Enumeration date
09/13/2006
Last updated
05/13/2016
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