MEDICARE: LADAWN C REID CRNA

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	367500000X	Certified Registered Nurse Anesthetist	24021.0858	WY
2	367500000X	Certified Registered Nurse Anesthetist	3002232	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770560906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LADAWN C REID CRNA

Provider Business Mailing Address
First Line	:	425 LEWIS HARGETT CIR
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40503-3590
Country	:	US
Telephone Number	:	859-268-1030
Fax Number	:	859-269-4120

Provider Business Practice Location Address
First Line	:	1221 SOUTH LIMESTONE STREET
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504
Country	:	US
Telephone Number	:	859-258-4600
Fax Number	:

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

Provider Enumeration Date	:	12/29/2005
Last Update Date	:	02/02/2016

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Directions to “ LADAWN C REID CRNA” Practice Location

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