Provider Demographics
NPI:1194887570
Name:REYNOLDS, WENDY E (MSN ACFNPC)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:E
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:MSN ACFNPC
Other - Prefix:MISS
Other - First Name:WENDY
Other - Middle Name:ELISE
Other - Last Name:ELROD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2010 CHURCH STREET
Mailing Address - Street 2:SUITE 420
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2012
Mailing Address - Country:US
Mailing Address - Phone:615-329-2141
Mailing Address - Fax:615-321-0522
Practice Address - Street 1:2010 CHURCH STREET
Practice Address - Street 2:SUITE 420
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2012
Practice Address - Country:US
Practice Address - Phone:615-329-2141
Practice Address - Fax:615-321-0522
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12489363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ75976Medicare UPIN
TN103I703747Medicare PIN
TN3644144Medicare PIN