Provider Demographics
NPI:1285834242
Name:REED, LYNDA LEANNE (NP)
Entity Type:Individual
Prefix:MRS
First Name:LYNDA
Middle Name:LEANNE
Last Name:REED
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1532 ELDERTREE DR
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-3919
Mailing Address - Country:US
Mailing Address - Phone:909-396-0053
Mailing Address - Fax:
Practice Address - Street 1:1532 ELDERTREE DR
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-3919
Practice Address - Country:US
Practice Address - Phone:909-396-0053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANPF 15070363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner