Provider Demographics
NPI:1871500744
Name:REYNOLDS, DEBBIE KAY (PHD, MSN, FNP, PMHNP)
Entity Type:Individual
Prefix:MS
First Name:DEBBIE
Middle Name:KAY
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:PHD, MSN, FNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7421 S 36TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-5701
Mailing Address - Country:US
Mailing Address - Phone:402-486-9373
Mailing Address - Fax:402-882-7554
Practice Address - Street 1:233 S 13TH ST STE 1100
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68508-2003
Practice Address - Country:US
Practice Address - Phone:402-486-9373
Practice Address - Fax:402-882-7554
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110769363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE38770OtherBCBS
NE39196OtherBCBS
NE10025423000Medicaid
NE280609Medicare PIN
NEQ73338Medicare UPIN
NE281665Medicare PIN
251069OtherMIDLANDS CHOICE