Healthcare Provider Details

I. General information

NPI: 1437076403
Provider Name (Legal Business Name): STEFANIE MICHELLE REED CHW, MARS, MRSS, PPF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W COATES ST STE 201
MOBERLY MO
65270-1552
US

IV. Provider business mailing address

518 VINCIL ST
MOBERLY MO
65270-2571
US

V. Phone/Fax

Practice location:
  • Phone: 660-263-7173
  • Fax:
Mailing address:
  • Phone: 660-263-7173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number15378
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: