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General NPI Number Information
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NPI Number | 1952793663
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Entity Type | Individual
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Provider Name | JESSICA REYNOLDS R.N.
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Gender | Female
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Dates
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Enumeration Date | 03/04/2015
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Last Update Date | 03/04/2015
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Provider Practice Location Address
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Address Line | 2645 N WALNUT AVE
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City | TUCSON
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State | AZ
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Zip | 85712-1827
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Country | US
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Telephone | 520-603-5275
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Fax |
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Provider Business Mailing Address
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Address Line | 2645 N WALNUT AVE
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City | TUCSON
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State | AZ
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Zip | 85712-1827
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Country | US
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Telephone | 520-603-5275
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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 | 163WC3500X
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Taxonomy Name | Cardiac Rehabilitation Registered Nurse
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License Number | RN176400
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License Number State | AZ
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