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General NPI Number Information
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NPI Number | 1235499930
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Entity Type | Individual
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Provider Name | DIXIE LEAH REYNOLDS ARNP
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Gender | Female
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Dates
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Enumeration Date | 05/29/2012
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Last Update Date | 06/18/2014
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Provider Practice Location Address
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Address Line | 202 N DIVISION ST STE 202
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City | AUBURN
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State | WA
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Zip | 98001-4939
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Country | US
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Telephone | 253-876-8088
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Fax |
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Provider Business Mailing Address
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Address Line | 202 N DIVISION ST STE 202
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City | AUBURN
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State | WA
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Zip | 98001-4939
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Country | US
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Telephone | 253-876-8088
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | ARNP9219864
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | AP60448863
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP60448863
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License Number State | WA
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