Provider Demographics
NPI:1710725932
Name:REYNOLDS, ADAM WEST (CRNP)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:WEST
Last Name:REYNOLDS
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 CORNERSTONE DRIVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MOUNT JOY
Mailing Address - State:PA
Mailing Address - Zip Code:17552-9416
Mailing Address - Country:US
Mailing Address - Phone:717-598-4022
Mailing Address - Fax:
Practice Address - Street 1:1001 CORNERSTONE DR
Practice Address - Street 2:
Practice Address - City:MOUNT JOY
Practice Address - State:PA
Practice Address - Zip Code:17552-9416
Practice Address - Country:US
Practice Address - Phone:717-653-2929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-20
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP030190363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily