Reynolds, Tamara J

Reynolds, Tamara J is an individual health care provider with primary practice located at 909 E State Blvd , Fort Wayne IN 46805-3404. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Reynolds, Tamara J can be contacted via phone (260) 481-2700.

Contact Information

Primary practice address
909 E State Blvd Fort Wayne IN 46805-3404
Phone: (260) 481-2700
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71000376 Indiana
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 71000376A Indiana

Profile Details

NPI number 1336237320
LBN Legal business name Reynolds, Tamara J
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 11th, 2006
Last updated Jul 16th, 2014 - about 10 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1336237320 NPPES
Indiana Other M900020621 MEDICARE PTAN
Indiana MEDICAID 200196310 MEDICARE PTAN

Popular Providers