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General NPI Number Information
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NPI Number | 1295500189
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Entity Type | Individual
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Provider Name | ISABELLE THALA REED SOUTH PA
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Gender | Female
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Dates
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Enumeration Date | 11/20/2023
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 4921 PARKVIEW PL DIV IM ENDOCRINOLOGY, STE 5C
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City | SAINT LOUIS
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State | MO
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Zip | 63110-1032
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Country | US
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Telephone | 314-362-3500
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Fax | 314-230-1119
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Provider Business Mailing Address
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Address Line | 4921 PARKVIEW PL STE 13B
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City | SAINT LOUIS
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State | MO
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Zip | 63110-1032
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2023044681
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 85.010028
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License Number State | IL
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