MEDICARE: TONYA AILEEN REYNOLDS

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
1	251E00000X	Home Health Agency	NA.00711640	CO

General Provider Information

NPI Number	:	1356911192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONYA AILEEN REYNOLDS

Provider Business Mailing Address
First Line	:	6816 MILLBROOK CIR
Second Line	:
City	:	FOUNTAIN
State	:	CO
Zip	:	80817-1324
Country	:	US
Telephone Number	:	719-502-5765
Fax Number	:

Provider Business Practice Location Address
First Line	:	6816 MILLBROOK CIR
Second Line	:
City	:	FOUNTAIN
State	:	CO
Zip	:	80817-1324
Country	:	US
Telephone Number	:	719-502-5765
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2021
Last Update Date	:	05/21/2026

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