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General NPI Number Information
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NPI Number | 1659134054
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Entity Type | Individual
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Provider Name | DESHA REID REGISTERED NURSE
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Gender | Female
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Dates
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Enumeration Date | 01/30/2024
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Last Update Date | 08/26/2026
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Provider Practice Location Address
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Address Line | 83 SHEPARD AVE
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City | TEANECK
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State | NJ
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Zip | 07666-6119
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Country | US
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Telephone | 347-650-1591
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Fax |
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Provider Business Mailing Address
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Address Line | 83 SHEPARD AVE
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City | TEANECK
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State | NJ
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Zip | 07666-6119
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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 | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 704198
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F409093-01
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License Number State | NY
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