Provider Demographics
NPI:1881283893
Name:REYNOLDS, RACHEL ARLENE (NP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ARLENE
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 CHURCHMANS RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-1946
Mailing Address - Country:US
Mailing Address - Phone:607-743-9354
Mailing Address - Fax:
Practice Address - Street 1:620 CHURCHMANS RD
Practice Address - Street 2:SUITE 203
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-1945
Practice Address - Country:US
Practice Address - Phone:607-743-9354
Practice Address - Fax:302-285-2264
Is Sole Proprietor?:No
Enumeration Date:2021-01-14
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0011540363L00000X
DEL8-0010713363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner