Provider Demographics
NPI:1154355527
Name:REYNOLDS, FRANCES MARIE (NP)
Entity type:Individual
Prefix:MS
First Name:FRANCES
Middle Name:MARIE
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:1882 QUENDALE LN
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381-1344
Mailing Address - Country:US
Mailing Address - Phone:248-396-1448
Mailing Address - Fax:248-685-7609
Practice Address - Street 1:221 S MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-2653
Practice Address - Country:US
Practice Address - Phone:248-545-9200
Practice Address - Fax:248-545-9210
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704118039363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIQ43162Medicare UPIN
MIOP16700003Medicare ID - Type Unspecified