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General NPI Number Information
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NPI Number | 1992223895
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Entity Type | Individual
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Provider Name | CASSANDRA K REED FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/31/2017
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Last Update Date | 08/20/2021
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Provider Practice Location Address
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Address Line | 1036 W STEPHENSON ST
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City | FREEPORT
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State | IL
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Zip | 61032-4865
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Country | US
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Telephone | 815-599-7770
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Fax | 815-599-7613
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Provider Business Mailing Address
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Address Line | 421 W EXCHANGE ST
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City | FREEPORT
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State | IL
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Zip | 61032-4008
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Country | US
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Telephone | 815-599-7925
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Fax | 815-599-7923
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 209-016378
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License Number State | IL
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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 | 209016378
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 209-016378
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License Number State | IL
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