Provider Demographics
NPI:1609677764
Name:REYNOLDS, MELINDA DELL
Entity type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:DELL
Last Name:REYNOLDS
Suffix:
Gender:
Credentials:
Other - Prefix:MISS
Other - First Name:MELINDA
Other - Middle Name:DELL
Other - Last Name:VAN ARSDALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4907 TALLGRASS PL
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-8440
Mailing Address - Country:US
Mailing Address - Phone:308-482-0601
Mailing Address - Fax:
Practice Address - Street 1:4907 TALLGRASS PL
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-8440
Practice Address - Country:US
Practice Address - Phone:308-482-0601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant