Healthcare Provider Details

I. General information

NPI: 1003734534
Provider Name (Legal Business Name): COURTNEY PAIGE REED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 W JIMMIE LEEDS RD
POMONA NJ
08240-9102
US

IV. Provider business mailing address

528 CORNWALL DR
GALLOWAY NJ
08205-3251
US

V. Phone/Fax

Practice location:
  • Phone: 609-335-8012
  • Fax:
Mailing address:
  • Phone: 609-335-8012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number26NR24430100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: