Most Relevant Information
Provider Data
| NPI Number: | 1003021759 |
| Provider Name: | JACKIE SUE REYNOLDS LPN |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | PN090469 |
Most Important Dates
| Enumeration Date: | 05/14/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
199 TROTTERS CIR
DELAWARE
OH
430153373
Practice Location Phone/Fax
| Phone: | 7409908832 |
| Fax: |
Provider Mailing Location
199 TROTTERS CIR
DELAWARE
OH
430153373
Provider Mailing Phone/Fax
| Phone: | 7409908832 |
| Fax: |