Healthcare Provider Details

I. General information

NPI: 1437144862
Provider Name (Legal Business Name): LORIE REED CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 CRESTMARK DR SUITE 200
LITHIA SPRINGS GA
30122-2646
US

IV. Provider business mailing address

880 CRESTMARK DR SUITE 200
LITHIA SPRINGS GA
30122-2646
US

V. Phone/Fax

Practice location:
  • Phone: 770-941-8662
  • Fax: 770-739-6006
Mailing address:
  • Phone: 770-941-8662
  • Fax: 770-739-6006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberRN098034
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: