Doctor Name: | WENDY REYNOLDS |
NPI Number: | 1215353040 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 64891 |
Business Practice Address: | 1136 Kincaid Bridge Rd Winnsboro, SC - 291807116 |
Business Phone Number: | 8036356481 |
Business Fax Number: | 8036351410 |
Mailing Address: | 10736 Wilson Blvd, BLYTHEWOOD |
State: | SC |
Postal Code: | 290169011 |
Phone Number: | 8035180916 |
Fax Number: | 8036351410 |
NPI Enumeration Date: | 03/18/2014 |
NPI Last Update Date: | 03/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WC1500X |
License Number: | 64891 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Community Health |
Taxonomy Definition: |