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NPI Code Detail

MEDICARE: MS. CHARLENE MYERS REID R.N.

MEDICARE: MS. CHARLENE MYERS REID R.N.
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN523810LPA
2163WG0000XGeneral Practice Registered NurseRN523810LPA

General Provider Information

NPI Number : 1366693640
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CHARLENE MYERS REID R.N.
Provider Business Mailing Address
First Line : 1931 MIFFLIN ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19145-2020
Country : US
Telephone Number : 215-463-5908
Fax Number :
Provider Business Practice Location Address
First Line : 1931 MIFFLIN ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19145-2020
Country : US
Telephone Number : 215-463-5908
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2008
Last Update Date : 10/06/2008

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Directions to “ MS. CHARLENE MYERS REID R.N.” Practice Location

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