Provider Demographics
NPI:1093188187
Name:REYNOLDS, SARAH MARIE (RN, CRNA)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MARIE
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:RN, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:965 FLORIDA AVE NW APT 258
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-5568
Mailing Address - Country:US
Mailing Address - Phone:860-558-6496
Mailing Address - Fax:
Practice Address - Street 1:1710 10TH ST NW # 1
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-5009
Practice Address - Country:US
Practice Address - Phone:860-558-6496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-11
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT94903163W00000X
MDR213116163W00000X, 367500000X
DCRN1027280163W00000X, 367500000X
VA0001243008163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse