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General NPI Number Information
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NPI Number | 1568961456
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Entity Type | Individual
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Provider Name | TAMEKA RUCKS REYNOLDS NP
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Gender | Female
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Dates
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Enumeration Date | 02/06/2018
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 14001 E ILIFF AVE FL 4
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City | AURORA
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State | CO
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Zip | 80014-1405
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Country | US
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Telephone | 912-414-1480
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Fax |
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Provider Business Mailing Address
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Address Line | 21004 E QUINCY PL
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City | AURORA
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State | CO
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Zip | 80015-3805
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Country | US
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Telephone | 912-414-1480
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN203695
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License Number State | GA
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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 | 1-165183
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | C-APN.0102661-C-NP
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License Number State | CO
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