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NPI Code Detail

MEDICARE: LYDIA REID

MEDICARE: LYDIA REID
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
1363LP0200XPediatric Nurse Practitioner2025004021MO

General Provider Information

NPI Number : 1356146534
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYDIA REID
Provider Business Mailing Address
First Line : 808 SW STABLEWOOD CIR
Second Line :
City : LEES SUMMIT
State : MO
Zip : 64081-3296
Country : US
Telephone Number : 816-813-7457
Fax Number :
Provider Business Practice Location Address
First Line : 503 N SCOTT AVE
Second Line :
City : BELTON
State : MO
Zip : 64012-1730
Country : US
Telephone Number : 816-322-4769
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2025
Last Update Date : 02/13/2025

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Directions to “ LYDIA REID ” Practice Location

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