MEDICARE: JAIREA REED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	372500000X	Chore Provider
2	374U00000X	Home Health Aide
3	376K00000X	Nurse's Aide

General Provider Information

NPI Number	:	1144697590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAIREA REED

Provider Business Mailing Address
First Line	:	811 NEIGHBOR LN
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63137-3433
Country	:	US
Telephone Number	:	314-339-9417
Fax Number	:

Provider Business Practice Location Address
First Line	:	811 NEIGHBOR LN
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63137-3433
Country	:	US
Telephone Number	:	314-339-9417
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2015
Last Update Date	:	09/01/2015

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