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General NPI Number Information
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NPI Number | 1811394885
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Entity Type | Individual
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Provider Name | AMANDA REYNOLDS RN
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Gender | Female
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Dates
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Enumeration Date | 11/19/2014
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 4575 8TH DIVISION ROAD
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City | COLUMBIA
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State | SC
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Zip | 29207
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Country | US
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Telephone | 803-751-7826
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Fax | 803-751-4438
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Provider Business Mailing Address
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Address Line | 64 BELLSIDE LN
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City | ELGIN
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State | SC
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Zip | 29045-5501
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Country | US
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Telephone | 828-446-0106
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0001238577
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 244621
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License Number State | SC
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