MEDICARE: LOVINE KERRON REID CNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide		AL

General Provider Information

NPI Number	:	1154101210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOVINE KERRON REID CNA

Provider Business Mailing Address
First Line	:	4 POND CIR
Second Line	:
City	:	FORESTDALE
State	:	MA
Zip	:	02644-1647
Country	:	US
Telephone Number	:	774-368-4797
Fax Number	:

Provider Business Practice Location Address
First Line	:	19000 OAK RD W
Second Line	:
City	:	GULF SHORES
State	:	AL
Zip	:	36542-5662
Country	:	US
Telephone Number	:	774-368-4797
Fax Number	:	774-521-3746

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2023
Last Update Date	:	10/04/2023

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Directions to “ LOVINE KERRON REID CNA” Practice Location

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