Provider Demographics
NPI:1457646663
Name:REYNOLDS, CHRISTE DANIELLE (RPH)
Entity Type:Individual
Prefix:MS
First Name:CHRISTE
Middle Name:DANIELLE
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 PAVILION PKWY
Mailing Address - Street 2:T-2483
Mailing Address - City:NEWPORT
Mailing Address - State:KY
Mailing Address - Zip Code:41071-2884
Mailing Address - Country:US
Mailing Address - Phone:859-814-0140
Mailing Address - Fax:
Practice Address - Street 1:160 PAVILION PKWY
Practice Address - Street 2:T-2483
Practice Address - City:NEWPORT
Practice Address - State:KY
Practice Address - Zip Code:41071-2884
Practice Address - Country:US
Practice Address - Phone:859-814-0140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-15
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03230100183500000X
KY012166183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist