Healthcare Provider Details

I. General information

NPI: 1114567344
Provider Name (Legal Business Name): ANGELIA ELAINE REED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2020
Last Update Date: 01/15/2020
Certification Date: 01/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

342 WALLER AVE APT 2D
LEXINGTON KY
40504-2909
US

IV. Provider business mailing address

342 WALLER AVE APT 2D
LEXINGTON KY
40504-2909
US

V. Phone/Fax

Practice location:
  • Phone: 859-608-7260
  • Fax:
Mailing address:
  • Phone: 859-608-7260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: