Healthcare Provider Details

I. General information

NPI: 1124954060
Provider Name (Legal Business Name): JEANNETTE REED NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 E COMMERCIAL AVE
LOWELL IN
46356-2307
US

IV. Provider business mailing address

929 E COMMERCIAL AVE
LOWELL IN
46356-2307
US

V. Phone/Fax

Practice location:
  • Phone: 219-233-5400
  • Fax: 219-292-4100
Mailing address:
  • Phone: 219-233-5400
  • Fax: 219-292-4100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number28138275A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number28138275A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: