Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
GLORIOUS LATRIC WILSON-REYNOLDS, CPNP
ActiveGLORIOUS LATRIC WILSON-REYNOLDS, CPNP is a Pediatric Nurse Practitioner healthcare provider located in LA PORTE, Indiana. NPI 1376898320 is currently active in the NPPES registry. Verify at CMS.
Pediatric Nurse Practitioner · LA PORTE, IN
Registration Details
- NPI Number
- 1376898320
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jul 16, 2012 (14.041870219071 yrs)
- Last Updated
- Sep 28, 2020
- Licenses
-
209008737 (IL)71005286A (IN)
Practice Information
- Address
-
1509 STATE STLA PORTE, IN, 463503115Browse IN providers · Browse ZIP 46350
- Phone
- 2193243431
- Fax
- 2193623802
- Primary Specialty
-
Pediatric Nurse Practitioner
363LP0200X
- Additional Specialty
- Pediatric Nurse Practitioner
Other Pediatric Nurse Practitioner Providers in LA PORTE, IN
| Name | Credential | NPI |
|---|---|---|
| MRS. JENNIFER CAMPBELL | CPNP | 1023232477 |
| MS. KRISTA MARIE NASTAJ | MSN, RN, CPNP-PC | 1639799935 |
| TAYLOR ANN GREEN | — | 1770366825 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.