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General NPI Number Information
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NPI Number | 1861062945
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Entity Type | Individual
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Provider Name | NICOLE A REID APRN
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Gender | Female
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Dates
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Enumeration Date | 06/30/2021
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 2955 BROWNWOOD BLVD STE 107
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City | THE VILLAGES
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State | FL
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Zip | 32163-2040
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Country | US
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Telephone | 352-765-7100
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Fax | 352-430-0210
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Provider Business Mailing Address
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Address Line | PO BOX 102222
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City | ATLANTA
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State | GA
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Zip | 30368-2222
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Country | US
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Telephone | 239-274-8200
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F06211557
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11038207
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License Number State | FL
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