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NPI 1003897695

NPI 1003897695 : ALINA REYNOLDS CRNA : ALLENTOWN, PA

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General NPI Number Information
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    NPI Number           |    1003897695
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    Entity Type          |    Individual 
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    Provider Name        |    ALINA REYNOLDS CRNA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/10/2005
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    Last Update Date     |    06/06/2013
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Provider Practice Location Address
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    Address Line         |    1245 S CEDAR CREST BLVD STE 301 
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    City                 |    ALLENTOWN
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    State                |    PA
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    Zip                  |    18103-6258
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    Country              |    US
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    Telephone            |    610-402-8896
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    Fax                  |    610-402-9029
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Provider Business Mailing Address
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    Address Line         |    1245 S CEDAR CREST BLVD STE 301 
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    City                 |    ALLENTOWN
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    State                |    PA
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    Zip                  |    18103-6258
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    Country              |    US
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    Telephone            |    610-402-8896
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    Fax                  |    610-402-9029
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    163WC0200X
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    Taxonomy Name        |    Critical Care Medicine Registered Nurse
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    License Number       |    R148560
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    License Number State |    MD
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Taxonomy #2
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    Taxonomy Code        |    367500000X
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    Taxonomy Name        |    Certified Registered Nurse Anesthetist
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    License Number       |    89286
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    License Number State |    PA
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