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NPI Code Detail

MEDICARE: CARMEN L. REYNOLDS RN, BSN

MEDICARE: CARMEN L. REYNOLDS RN, BSN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN 036682AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RN 036682OTHERAZRN

General Provider Information

NPI Number : 1295924074
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARMEN L. REYNOLDS RN, BSN
Provider Business Mailing Address
First Line : 102 N PLUMER AVE
Second Line :
City : TUCSON
State : AZ
Zip : 85719-5906
Country : US
Telephone Number : 520-225-4317
Fax Number : 520-225-4515
Provider Business Practice Location Address
First Line : 102 N PLUMER AVE
Second Line :
City : TUCSON
State : AZ
Zip : 85719-5906
Country : US
Telephone Number : 520-225-4317
Fax Number : 520-225-4515
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2007
Last Update Date : 12/21/2007

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