Provider Demographics
NPI:1114502366
Name:REED, AUDREY MARIE (MOBILE PHLEBOTOMIST)
Entity Type:Individual
Prefix:MS
First Name:AUDREY
Middle Name:MARIE
Last Name:REED
Suffix:
Gender:F
Credentials:MOBILE PHLEBOTOMIST
Other - Prefix:MS
Other - First Name:AUDREY
Other - Middle Name:MARIE
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHLEBOTOMIST
Mailing Address - Street 1:3222 WINCHESTER HWY
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37342-3737
Mailing Address - Country:US
Mailing Address - Phone:931-315-9736
Mailing Address - Fax:931-233-9961
Practice Address - Street 1:3222 WINCHESTER HWY
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:TN
Practice Address - Zip Code:37342-3737
Practice Address - Country:US
Practice Address - Phone:931-315-9736
Practice Address - Fax:931-233-9961
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1103540202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Single Specialty