Healthcare Provider Details

I. General information

NPI: 1154145860
Provider Name (Legal Business Name): MISS APRIL MICHELLE MCREYNOLDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2024
Last Update Date: 11/09/2024
Certification Date: 11/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3539 WHITETAIL LN
PENSACOLA FL
32526-4462
US

IV. Provider business mailing address

3539 WHITETAIL LN
PENSACOLA FL
32526-4462
US

V. Phone/Fax

Practice location:
  • Phone: 850-786-9212
  • Fax:
Mailing address:
  • Phone: 850-786-9212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License NumberRN9328110
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN9328110
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code163WR0400X
TaxonomyRehabilitation Registered Nurse
License NumberRN9328110
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License NumberRN9328110
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN9328110
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: