Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Miki Deneise Reynolds, NURSEPRACTITIONER

Individual provider Family Nurse Practitioner · NPI 1700411311

Miki Deneise Reynolds, NURSEPRACTITIONER is a Nurse Practitioner in Russellville, Arkansas. Qualified in 2019, 7 years ago. Accepts Medicare assignment. Licensed in Arkansas.

Years since qualifying
7
Licensed in
AR
In the registry since
2020
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Practice location Address checks out

2600 W Main St
Russellville, AR 72801-2535
Phone: (833) 479-4325
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 123647 (AR)

Record details

NPI number1700411311
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorNo
NPI enumeratedMarch 4, 2020
Last updated in NPPESMarch 30, 2026
Certification dateMarch 30, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Russellville