Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | F430480-1 | NY |
NPI | 1003048638 |
---|---|
Provider Name | Ms. Nicole Noelle Reynolds |
First Address | New York, NY 10065-6007 |
Second Address | New York, NY 10065-6007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2009 |
Last Update Date | 07/12/2018 |