MEDICARE: ANGELA REED NP

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	363LP0200X	Pediatric Nurse Practitioner	4704182710	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871533166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA REED NP

Provider Business Mailing Address
First Line	:	803 W ARLINGTON ST
Second Line	:	BANGOR HEALTH CENTER
City	:	BANGOR
State	:	MI
Zip	:	49013-1108
Country	:	US
Telephone Number	:	269-427-6810
Fax Number	:	269-427-6811

Provider Business Practice Location Address
First Line	:	803 W ARLINGTON ST
Second Line	:	BANGOR HEALTH CENTER
City	:	BANGOR
State	:	MI
Zip	:	49013-1108
Country	:	US
Telephone Number	:	269-427-6810
Fax Number	:	269-427-6811

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

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	01/23/2012

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