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General NPI Number Information
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NPI Number | 1346868320
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Entity Type | Individual
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Provider Name | PAOLA ANDREA REYNOLDS MSN, APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/07/2020
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 1855 KNOX MCRAE DR
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City | TITUSVILLE
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State | FL
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Zip | 32780-5492
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Country | US
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Telephone | 321-269-2028
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Fax | 321-264-0730
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Provider Business Mailing Address
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Address Line | 3300 S FISKE BLVD
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City | ROCKLEDGE
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State | FL
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Zip | 32955-4306
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Country | US
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Telephone | 321-269-2028
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11007865
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11007865
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License Number State | FL
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