Provider Demographics
NPI:1184183659
Name:REYNA, ENEDELIA (MSN, RN, NNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ENEDELIA
Middle Name:
Last Name:REYNA
Suffix:
Gender:F
Credentials:MSN, RN, NNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2203 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-3001
Mailing Address - Country:US
Mailing Address - Phone:956-467-3151
Mailing Address - Fax:
Practice Address - Street 1:222 E RIDGE RD STE 202
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1251
Practice Address - Country:US
Practice Address - Phone:956-994-9100
Practice Address - Fax:956-994-9101
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140974363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal