| Doctor Name: | MRS. LORA DIANE REYNOLDS |
| NPI Number: | 1063838654 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 0024171491 |
| Business Practice Address: | 16000 Johnston Memorial Dr Medical Plaza Suite 313 Abingdon, VA - 242117659 |
| Business Phone Number: | 2762583780 |
| Business Fax Number: | 2762583776 |
| Mailing Address: | 16000 Johnston Memorial Dr, Medical Plaza Suite 313 ABINGDON |
| State: | VA |
| Postal Code: | 242117659 |
| Phone Number: | 2762583780 |
| Fax Number: | 2762583776 |
| NPI Enumeration Date: | 03/06/2014 |
| NPI Last Update Date: | 03/22/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 0024171491 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |