Healthcare Provider Details

I. General information

NPI: 1609759836
Provider Name (Legal Business Name): KRYSTLE A REED RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRYSTLE A REED-BROWN RN

II. Dates (important events)

Enumeration Date: 07/28/2025
Last Update Date: 07/28/2025
Certification Date: 07/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 E INDIAN SCHOOL RD
PHOENIX AZ
85012-1839
US

IV. Provider business mailing address

15747 W JEFFERSON ST
GOODYEAR AZ
85338-6465
US

V. Phone/Fax

Practice location:
  • Phone: 602-277-5551
  • Fax:
Mailing address:
  • Phone: 623-522-1516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number905548
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN176700
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: