Provider Demographics
NPI:1316196728
Name:REED, JERRI RENEE (RN)
Entity Type:Individual
Prefix:
First Name:JERRI
Middle Name:RENEE
Last Name:REED
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 MEARS AVE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28716-4422
Mailing Address - Country:US
Mailing Address - Phone:828-242-9636
Mailing Address - Fax:
Practice Address - Street 1:22 MEARS AVE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:NC
Practice Address - Zip Code:28716-4422
Practice Address - Country:US
Practice Address - Phone:828-242-9636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI160480-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse