Provider Demographics
NPI:1063748101
Name:REYNOLDS, KAREN CHRISTINE (FNP-BC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:CHRISTINE
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:847 KENSINGTON CV
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-6286
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:VANTAGE POINT BEHAVIORAL HEALTH
Practice Address - Street 2:4253 CROSSOVER ROAD
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703
Practice Address - Country:US
Practice Address - Phone:479-310-8197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-24
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03309363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
2009998826OtherAMERICAN NURSES CREDENTIALING CENTER
ARA03309OtherARKANSAS STATE BOARD OF NURSING