Provider Demographics
NPI:1275212995
Name:REED, ALTICE
Entity Type:Individual
Prefix:
First Name:ALTICE
Middle Name:
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 1:441 KENWOOD DR APT P
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44123-2054
Mailing Address - Country:US
Mailing Address - Phone:216-704-7160
Mailing Address - Fax:
Practice Address - Street 1:441 KENWOOD DR APT P
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44123-2054
Practice Address - Country:US
Practice Address - Phone:216-704-7160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH180453164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse