MEDICARE: MRS. BRIANNE REED OTR/L

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	314000000X	Skilled Nursing Facility	U1-0001123	DE

General Provider Information

NPI Number	:	1477881456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BRIANNE REED OTR/L

Provider Business Mailing Address
First Line	:	387 GLENN FOREST RD
Second Line	:
City	:	MAGNOLIA
State	:	DE
Zip	:	19962-2729
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	387 GLENN FOREST RD
Second Line	:
City	:	MAGNOLIA
State	:	DE
Zip	:	19962-2729
Country	:	US
Telephone Number	:	862-452-7261
Fax Number	:

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

Provider Enumeration Date	:	12/02/2009
Last Update Date	:	12/02/2009

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