Provider Demographics
NPI:1801190079
Name:REYNOLDS, MEGAN CHERI (NP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:CHERI
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:CHERI
Other - Last Name:KIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1616 FM 685
Mailing Address - Street 2:SUITE 106
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-7536
Mailing Address - Country:US
Mailing Address - Phone:512-252-9094
Mailing Address - Fax:512-252-9095
Practice Address - Street 1:1616 FM 685
Practice Address - Street 2:SUITE 106
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-7536
Practice Address - Country:US
Practice Address - Phone:512-252-9094
Practice Address - Fax:512-252-9095
Is Sole Proprietor?:No
Enumeration Date:2011-01-03
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0910318363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily