Provider Demographics
NPI:1861152233
Name:REYNOLDS, JULIE KAY (CD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:KAY
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18450 LAZY SUMMER WAY
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-8795
Mailing Address - Country:US
Mailing Address - Phone:909-838-8409
Mailing Address - Fax:
Practice Address - Street 1:18450 LAZY SUMMER WAY
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-8795
Practice Address - Country:US
Practice Address - Phone:909-838-8409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-27
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL13726374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula