Provider Demographics
NPI:1093309106
Name:REYNOLDS, BRITTANY LANE (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LANE
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2665 BRICKY RD SOUTH
Mailing Address - Street 2:
Mailing Address - City:BEE BRANCH
Mailing Address - State:AR
Mailing Address - Zip Code:72013
Mailing Address - Country:US
Mailing Address - Phone:501-581-8252
Mailing Address - Fax:
Practice Address - Street 1:1150 E MATTHEWS AVE STE 101A
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-4356
Practice Address - Country:US
Practice Address - Phone:870-243-0424
Practice Address - Fax:534-248-4225
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-01
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR214914363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health