Healthcare Provider Details

I. General information

NPI: 1114492220
Provider Name (Legal Business Name): JOEY BROOKE REED FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2018
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 W MAIN ST
NEWARK OH
43055-5005
US

IV. Provider business mailing address

63 W MAIN ST
NEWARK OH
43055-5005
US

V. Phone/Fax

Practice location:
  • Phone: 740-641-6574
  • Fax: 740-422-1308
Mailing address:
  • Phone: 740-641-6574
  • Fax: 740-422-1308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.022700
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: