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General NPI Number Information
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NPI Number | 1669775672
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Entity Type | Individual
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Provider Name | KARA REYNOLDS
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Gender | Female
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Dates
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Enumeration Date | 12/13/2010
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Last Update Date | 05/24/2011
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Provider Practice Location Address
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Address Line | 1800 15TH ST SUITE 300
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City | GREELEY
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State | CO
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Zip | 80631-4500
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Country | US
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Telephone | 970-378-4475
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Fax |
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Provider Business Mailing Address
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Address Line | 5224 CORNERSTONE DR
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City | FORT COLLINS
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State | CO
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Zip | 80528-3077
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Country | US
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Telephone | 720-373-1910
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 3137
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License Number State | CO
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