Provider Demographics
NPI:1093953358
Name:MCREYNOLDS, LEANN MICHELLE (MSN, RN, CCNS-BC)
Entity Type:Individual
Prefix:
First Name:LEANN
Middle Name:MICHELLE
Last Name:MCREYNOLDS
Suffix:
Gender:F
Credentials:MSN, RN, CCNS-BC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:PO BOX 264
Mailing Address - Street 2:210 W MEYER
Mailing Address - City:FALLS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78113-0264
Mailing Address - Country:US
Mailing Address - Phone:830-254-9616
Mailing Address - Fax:
Practice Address - Street 1:4410 MEDICAL DR
Practice Address - Street 2:SUITE 440
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-6306
Practice Address - Country:US
Practice Address - Phone:210-692-9400
Practice Address - Fax:210-692-0971
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-25
Last Update Date:2009-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX670554364SC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SC0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCritical Care Medicine