Healthcare Provider Details

I. General information

NPI: 1013307461
Provider Name (Legal Business Name): PATRICIA ALEXIS REED PHYSICIAN ASSISTANT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2015
Last Update Date: 10/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3715 WILLIAMS BLVD SUITE 100
KENNER LA
70065-3075
US

IV. Provider business mailing address

2104 GAUSE BLVD W STE. A
SLIDELL LA
70460-4130
US

V. Phone/Fax

Practice location:
  • Phone: 504-465-4550
  • Fax: 504-465-8590
Mailing address:
  • Phone: 985-643-4575
  • Fax: 985-643-4513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number200785
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: