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General NPI Number Information
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NPI Number | 1326802117
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Entity Type | Individual
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Provider Name | KARENE REYNOLDS-JAMES APRN, ACNPC-AG
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Gender | Female
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Dates
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Enumeration Date | 02/12/2024
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Last Update Date | 03/26/2024
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Provider Practice Location Address
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Address Line | 2627 W EAU GALLIE BLVD STE 101
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City | MELBOURNE
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State | FL
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Zip | 32935-8303
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Country | US
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Telephone | 321-837-3820
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 100
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City | TITUSVILLE
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State | FL
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Zip | 32781-0100
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Country | US
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Telephone | 321-243-2558
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 11030486
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 11030486
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License Number State | FL
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