MEDICARE: SUSAN ANN REED RN

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	251K00000X	Public Health or Welfare Agency	1-0386624	AL

General Provider Information

NPI Number	:	1427196963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN ANN REED RN

Provider Business Mailing Address
First Line	:	711 SUNNY LANE LOOP
Second Line	:
City	:	WETUMPKA
State	:	AL
Zip	:	36092-9501
Country	:	US
Telephone Number	:	334-541-4555
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 MONROE ST
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36104-3735
Country	:	US
Telephone Number	:	334-206-5180
Fax Number	:

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

Provider Enumeration Date	:	02/04/2007
Last Update Date	:	07/08/2007

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