Reynolds, Bobby Dean

Reynolds, Bobby Dean is an individual health care provider with primary practice located at 1503 W Elk Ave , Elizabethton TN 37643-2876. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Reynolds, Bobby Dean can be contacted via phone (423) 543-6660.

Contact Information

Primary practice address
1503 W Elk Ave Elizabethton TN 37643-2876
Phone: (423) 543-6660
Fax: (423) 543-5133
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APN0000007649 Tennessee

Profile Details

NPI number 1356455174
LBN Legal business name Reynolds, Bobby Dean
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2006
Last updated Jan 4th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356455174 NPPES
Tennessee MEDICAID 1509464
Tennessee Other 1509464
Tennessee Other 4330448

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