Provider Demographics
NPI:1942236914
Name:REYNOLDS, CYNTHIA (FNP)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 DOCTORS PARK
Mailing Address - Street 2:
Mailing Address - City:GALAX
Mailing Address - State:VA
Mailing Address - Zip Code:24333-2277
Mailing Address - Country:US
Mailing Address - Phone:276-236-2947
Mailing Address - Fax:276-236-2927
Practice Address - Street 1:103 DOCTORS PARK
Practice Address - Street 2:
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-2277
Practice Address - Country:US
Practice Address - Phone:276-236-2947
Practice Address - Fax:276-236-2927
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024121231363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily