Holly Ann Reynolds, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

284768-1 Issued in NY

Practice address

962 Eagle LN
Camillus, NY 13031-1580

Phone

(315) 882-2974

NPI assigned

Nov 17, 2008

Last updated

Nov 17, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1226880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226880000000",
    "number": "1326293465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "962 EAGLE LN",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130311580",
            "telephone_number": "315-882-2974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "962 EAGLE LN",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130311580",
            "telephone_number": "315-882-2974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "HOLLY",
        "middle_name": "ANN",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-17",
        "last_updated": "2008-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "284768-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Siyun Ren, OD
• Dennis E. Resetarits, M.D.
• Catherine Murphy Rewakowski
• Cheryl L Reynolds-Bowles, LPN
• Dermot M. Reynolds, M.D.
• Lee Rhynders
• Patrick J. Riccardi, MD
• Paul Sheridan Riker, CASAC
• Kime J Ristoff, MD
• Thomas Michael Rivard, PTA

• Licensed Practical Nurse in Camillus, NY
• Providers in Camillus, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.