Provider Demographics
NPI:1447748876
Name:REYMORE, KATHRYN ELAINE (RN)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:ELAINE
Last Name:REYMORE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3144 D ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503-5211
Mailing Address - Country:US
Mailing Address - Phone:707-599-8355
Mailing Address - Fax:
Practice Address - Street 1:2370 BUHNE ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-3237
Practice Address - Country:US
Practice Address - Phone:707-442-5721
Practice Address - Fax:707-442-6918
Is Sole Proprietor?:No
Enumeration Date:2018-05-01
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA740853163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse