Healthcare Provider Details

I. General information

NPI: 1750367934
Provider Name (Legal Business Name): RUTH LYNN REED ADVANCED REGISTERED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 03/26/2008
Certification Date:
Deactivation Date: 08/07/2007
Reactivation Date: 03/26/2008

III. Provider practice location address

537 S FREEBORN ST
MARION KS
66861-1256
US

IV. Provider business mailing address

537 S FREEBORN ST
MARION KS
66861-1256
US

V. Phone/Fax

Practice location:
  • Phone: 620-382-3722
  • Fax: 620-382-3851
Mailing address:
  • Phone: 620-382-3722
  • Fax: 620-382-3851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number44316
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: