Provider Demographics
NPI:1932489564
Name:REYNOLDS, DEBRA FLORES (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:FLORES
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12740 N ARBOR WAY
Mailing Address - Street 2:
Mailing Address - City:PLATTE CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64079-7804
Mailing Address - Country:US
Mailing Address - Phone:816-858-7708
Mailing Address - Fax:
Practice Address - Street 1:2301 RUNNING HORSE RD
Practice Address - Street 2:
Practice Address - City:PLATTE CITY
Practice Address - State:MO
Practice Address - Zip Code:64079-7703
Practice Address - Country:US
Practice Address - Phone:816-431-0327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-26
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY012563183500000X
MO2009018212183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist