Individual
KIMBERLY REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(540) 981-7000
Mailing address
5019 WILLIAMSBURG CT, ROANOKE, VA 24018-4198
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024-166226
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010102863
—
VA
05
—
010102880
—
VA
05
—
010102910
—
VA
05
—
010103355
—
VA
05
—
010103363
—
VA
Enumeration date
04/25/2006
Last updated
01/28/2009
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