Healthcare Provider Details

I. General information

NPI: 1902036999
Provider Name (Legal Business Name): JANICE DENISE REED CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2009
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 VALLEY ST STE 200
BALL GROUND GA
30107-4068
US

IV. Provider business mailing address

470 VALLEY ST STE 200
BALL GROUND GA
30107-4068
US

V. Phone/Fax

Practice location:
  • Phone: 770-737-2770
  • Fax: 770-737-2406
Mailing address:
  • Phone: 770-737-2770
  • Fax: 770-737-2406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN129274
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: