Individual
WADE REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
3061 E VALLEJO DR, GILBERT, AZ 85298-9059
(480) 248-4154
Mailing address
3317 S HIGLEY RD STE 114, GILBERT, AZ 85297-5437
(480) 248-4154
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
RN183469
AZ
363L00000X
Nurse Practitioner
Primary
225061
AZ
Other
Enumeration date
05/14/2018
Last updated
04/22/2019
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