Provider Demographics
NPI:1881327849
Name:REYNOLDS, TAMARA LEIGH (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:LEIGH
Last Name:REYNOLDS
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Gender:F
Credentials:FNP-C
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Mailing Address - Street 1:24530 FALCON PLACE BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24211-7665
Mailing Address - Country:US
Mailing Address - Phone:276-619-3801
Mailing Address - Fax:276-619-3810
Practice Address - Street 1:117 COOK ST
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-3203
Practice Address - Country:US
Practice Address - Phone:276-619-5052
Practice Address - Fax:276-619-5115
Is Sole Proprietor?:No
Enumeration Date:2022-07-07
Last Update Date:2024-01-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN35341363L00000X
VA0024184618363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner