Provider Demographics
NPI:1588690945
Name:RAYNOLDS, ABIGAIL R (ARNP)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:R
Last Name:RAYNOLDS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8550 MARSHALL DR
Mailing Address - Street 2:STE 100
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66214-1505
Mailing Address - Country:US
Mailing Address - Phone:913-894-1500
Mailing Address - Fax:913-894-1502
Practice Address - Street 1:8550 MARSHALL DR
Practice Address - Street 2:STE 100
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66214-1505
Practice Address - Country:US
Practice Address - Phone:913-894-1500
Practice Address - Fax:913-894-1502
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS13-48978-101163WG0000X
MO097940163WG0000X, 363LA2200X
KS44902363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Not Answered363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO097940OtherMO ANP LICENSE
KS44902OtherKS ARNP LICENSE
KS44902OtherKS ARNP LICENSE