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NPI Code Detail

MEDICARE: HOLLY ALEXIS REED FNP

MEDICARE:   HOLLY ALEXIS REED  FNP
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
1163W00000XRegistered Nurse689220NY
2363LF0000XFamily Nurse Practitioner345077NY

General Provider Information

NPI Number : 1588107031
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOLLY ALEXIS REED FNP
Provider Business Mailing Address
First Line : 4936 MAIN ST
Second Line :
City : BEMUS POINT
State : NY
Zip : 14712-9667
Country : US
Telephone Number : 716-386-2414
Fax Number : 716-386-2437
Provider Business Practice Location Address
First Line : 4936 MAIN ST
Second Line :
City : BEMUS POINT
State : NY
Zip : 14712-9667
Country : US
Telephone Number : 716-386-2414
Fax Number : 716-386-2437
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2016
Last Update Date : 10/01/2020

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Directions to “ HOLLY ALEXIS REED FNP” Practice Location

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