Healthcare Provider Details

I. General information

NPI: 1356840292
Provider Name (Legal Business Name): REGINA REED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2018
Last Update Date: 06/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

791 CHAMBERS RD
AURORA CO
80011-7112
US

IV. Provider business mailing address

11059 E BETHANY DR
AURORA CO
80014-2622
US

V. Phone/Fax

Practice location:
  • Phone: 303-617-2300
  • Fax:
Mailing address:
  • Phone: 303-617-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number1617050
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: