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General NPI Number Information
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NPI Number | 1215504857
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Entity Type | Individual
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Provider Name | LAURA ELIZABETH SMITH REYNOLDS CNM
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Gender | Female
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Dates
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Enumeration Date | 06/10/2021
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 12221 N MOPAC EXPY
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City | AUSTIN
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State | TX
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Zip | 78758-2401
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Country | US
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Telephone | 512-901-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 777 LOWNDES HILL RD BLDG 1
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City | GREENVILLE
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State | SC
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Zip | 29607-2101
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Country | US
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Telephone |
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Fax |
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 853993
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 1129160
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 853993
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License Number State | NV
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Taxonomy #4
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 1129160
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License Number State | TX
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