Healthcare Provider Details

I. General information

NPI: 1811710965
Provider Name (Legal Business Name): SHARON MARIE REYNOLDS APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2024
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3187 WESTERN ROW RD STE 116
MAINEVILLE OH
45039-8014
US

IV. Provider business mailing address

7217 CINCINNATI DAYTON RD
WEST CHESTER OH
45069-1547
US

V. Phone/Fax

Practice location:
  • Phone: 513-204-5734
  • Fax:
Mailing address:
  • Phone: 513-759-3301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0038002
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: