Provider Demographics
NPI:1083939409
Name:REED, ROXANN ELIZABETH (LPN)
Entity Type:Individual
Prefix:MS
First Name:ROXANN
Middle Name:ELIZABETH
Last Name:REED
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 1:3394 LEAP RD
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-1834
Mailing Address - Country:US
Mailing Address - Phone:614-804-4023
Mailing Address - Fax:
Practice Address - Street 1:3394 LEAP RD
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-1834
Practice Address - Country:US
Practice Address - Phone:614-806-4023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-29
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.134100-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse