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NPI Code Detail

MEDICARE: MIKAYLA QUINN REYNOLDS PA-C

MEDICARE:   MIKAYLA QUINN REYNOLDS  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantMA065172PA

General Provider Information

NPI Number : 1619749140
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIKAYLA QUINN REYNOLDS PA-C
Provider Business Mailing Address
First Line : 9 IDLEWOOD DR
Second Line :
City : DALLAS
State : PA
Zip : 18612-9027
Country : US
Telephone Number : 570-954-4506
Fax Number :
Provider Business Practice Location Address
First Line : 3371 ROUTE 100 FL 3
Second Line :
City : MACUNGIE
State : PA
Zip : 18062-9613
Country : US
Telephone Number : 610-967-2772
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2023
Last Update Date : 03/06/2026

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Directions to “ MIKAYLA QUINN REYNOLDS PA-C” Practice Location

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