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General NPI Number Information
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NPI Number | 1962810192
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Entity Type | Individual
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Provider Name | RHONDA REYNOLDS RN
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Gender | Female
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Dates
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Enumeration Date | 07/31/2014
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Last Update Date | 07/31/2014
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Provider Practice Location Address
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Address Line | 800 E 6TH AVE STE B
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City | STILLWATER
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State | OK
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Zip | 74074-3732
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Country | US
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Telephone | 580-762-7561
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Fax | 580-762-2576
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Provider Business Mailing Address
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Address Line | 4910 HALEY LN
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City | STILLWATER
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State | OK
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Zip | 74074-8619
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Country | US
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Telephone | 405-612-0049
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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 | 0057254
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License Number State | OK
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