Healthcare Provider Details

I. General information

NPI: 1174840433
Provider Name (Legal Business Name): AMANDA MAE REED R.N
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2010
Last Update Date: 04/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7193 CREEK RD
CAMDEN OH
45311-9626
US

IV. Provider business mailing address

7193 CREEK RD
CAMDEN OH
45311-9626
US

V. Phone/Fax

Practice location:
  • Phone: 513-283-1196
  • Fax:
Mailing address:
  • Phone: 513-283-1196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.357331
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: