Provider Demographics
NPI:1063016459
Name:REYNOLDS, EMILY ANN (CRNP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 GLENEAGLES DR
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17404-1147
Mailing Address - Country:US
Mailing Address - Phone:717-873-5231
Mailing Address - Fax:
Practice Address - Street 1:820 GLENEAGLES DR
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17404-1147
Practice Address - Country:US
Practice Address - Phone:717-873-5231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022485363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily