Provider Demographics
NPI:1538720768
Name:REYNOLDS, EDITH A (RN)
Entity type:Individual
Prefix:
First Name:EDITH
Middle Name:A
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947-2344
Mailing Address - Country:US
Mailing Address - Phone:302-752-1783
Mailing Address - Fax:302-854-0628
Practice Address - Street 1:505 W MARKET ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-2344
Practice Address - Country:US
Practice Address - Phone:302-752-1783
Practice Address - Fax:302-854-0628
Is Sole Proprietor?:No
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0017351163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health