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General NPI Number Information
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NPI Number | 1386227924
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Entity Type | Individual
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Provider Name | JAMIE SUE REYNOLDS FNP
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Gender | Female
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Dates
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Enumeration Date | 05/02/2021
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Last Update Date | 04/14/2022
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Provider Practice Location Address
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Address Line | 1661 STATE ROUTE 522 UNIT 2
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City | WHEELERSBURG
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State | OH
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Zip | 45694-8120
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Country | US
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Telephone | 740-574-1770
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Fax | 740-574-8781
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Provider Business Mailing Address
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Address Line | 739 MEADOW LN
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City | WHEELERSBURG
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State | OH
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Zip | 45694-8870
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F10201482
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License Number State | OH
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