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NPI Code Detail

MEDICARE: KRISTINA REYNOLDS

MEDICARE: KRISTINA REYNOLDS
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
1363LA2100XAcute Care Nurse Practitioner71005878AIN
2363LF0000XFamily Nurse Practitioner71005878AIN
3363LP2300XPrimary Care Nurse Practitioner71005878AIN

General Provider Information

NPI Number : 1952774762
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINA REYNOLDS
Provider Business Mailing Address
First Line : 1641 S US HIGHWAY 231
Second Line :
City : CRAWFORDSVILLE
State : IN
Zip : 47933-9421
Country : US
Telephone Number : 765-307-7146
Fax Number : 765-307-7146
Provider Business Practice Location Address
First Line : 1641 S US HIGHWAY 231
Second Line :
City : CRAWFORDSVILLE
State : IN
Zip : 47933-9421
Country : US
Telephone Number : 765-307-7146
Fax Number : 765-307-7146
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2015
Last Update Date : 11/03/2015

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Directions to “ KRISTINA REYNOLDS ” Practice Location

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