MEDICARE: DEIDRE REESE CNA

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
1	376K00000X	Nurse's Aide	CN0000129189	GA

General Provider Information

NPI Number	:	1790618312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEIDRE REESE CNA

Provider Business Mailing Address
First Line	:	450 CHAPPELL RD NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-6518
Country	:	US
Telephone Number	:	770-588-4221
Fax Number	:

Provider Business Practice Location Address
First Line	:	450 CHAPPELL RD NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-6518
Country	:	US
Telephone Number	:	770-588-4221
Fax Number	:

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

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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Directions to “ DEIDRE REESE CNA” Practice Location

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