Provider Demographics
NPI:1164985834
Name:REED, RAMEKA M
Entity Type:Individual
Prefix:
First Name:RAMEKA
Middle Name:M
Last Name:REED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 BLUE RIDGE TER
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-1303
Mailing Address - Country:US
Mailing Address - Phone:803-467-4269
Mailing Address - Fax:
Practice Address - Street 1:2301 BLUE RIDGE TER
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-1303
Practice Address - Country:US
Practice Address - Phone:803-467-4269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-10
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22783363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner