Healthcare Provider Details

I. General information

NPI: 1972856789
Provider Name (Legal Business Name): KATHI EILEEN REYNOLDS ACNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2012
Last Update Date: 10/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5520 CHEVIOT RD
CINCINNATI OH
45247-7069
US

IV. Provider business mailing address

5520 CHEVIOT RD
CINCINNATI OH
45247-7069
US

V. Phone/Fax

Practice location:
  • Phone: 513-451-4033
  • Fax:
Mailing address:
  • Phone: 513-451-4033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberNS-13809
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: