Healthcare Provider Details

I. General information

NPI: 1821445065
Provider Name (Legal Business Name): LINDSAY REYNOLDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2016
Last Update Date: 05/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 SAVANNAH RD
LEWES DE
19958
US

IV. Provider business mailing address

3620 RAVEN GROVE WAY APT. #331
KNOXVILLE TN
37918
US

V. Phone/Fax

Practice location:
  • Phone: 302-645-3300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN0000194653
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: