Provider Demographics
NPI:1013227164
Name:REID, ASHLEY ANN (LPN)
Entity Type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:ANN
Last Name:REID
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 ROWLAND ST
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-1629
Mailing Address - Country:US
Mailing Address - Phone:631-578-8138
Mailing Address - Fax:
Practice Address - Street 1:43 ROWLAND ST
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-1629
Practice Address - Country:US
Practice Address - Phone:631-578-8138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY301636164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse