Provider Demographics
NPI:1336805134
Name:REYNOLDS, ANECIA J (DNP, APN, PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ANECIA
Middle Name:J
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:DNP, APN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:DELRAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-1038
Mailing Address - Country:US
Mailing Address - Phone:609-781-2371
Mailing Address - Fax:
Practice Address - Street 1:668 MAIN ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NJ
Practice Address - Zip Code:08048-5016
Practice Address - Country:US
Practice Address - Phone:609-667-7353
Practice Address - Fax:609-667-7944
Is Sole Proprietor?:No
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01219000363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health