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General NPI Number Information
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NPI Number | 1811710965
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Entity Type | Individual
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Provider Name | SHARON MARIE REYNOLDS APRN, CNP
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Gender | Female
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Dates
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Enumeration Date | 11/06/2024
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 3187 WESTERN ROW RD
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City | MAINEVILLE
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State | OH
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Zip | 45039-8045
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Country | US
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Telephone | 513-770-4022
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Fax |
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Provider Business Mailing Address
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Address Line | 650 EMERALD DR
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City | SOUTH LEBANON
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State | OH
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Zip | 45065-3003
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Country | US
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Telephone | 937-474-4437
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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 | 0038002
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License Number State | OH
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