Individual
KIMBERLY L REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
30 PROSPECT AVE, HACKENSACK, NJ 07601-1915
(551) 996-2868
Mailing address
61 TRISTAN RD, CLIFTON, NJ 07013-1440
(862) 264-4477
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
26NJ00152900
NJ
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ00152900
NJ
Other
Enumeration date
04/28/2008
Last updated
08/26/2021
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