Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 21831 | TN |
N | 363LG0600X | Nurse Practitioner - Gerontology | 21831 | TN |
NPI | 1053869925 |
---|---|
Provider Name | Christopher L Reynolds |
First Address | Chattanooga, TN 37404-1161 |
Second Address | Chattanooga, TN 37404-1161 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2016 |
Last Update Date | 20/09/2016 |