Provider Demographics
NPI:1326218843
Name:REED, LAURA ANN (CNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:REED
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:MRS
Other - First Name:LAURA
Other - Middle Name:A
Other - Last Name:EMMERT-REED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:7453 PORT ROYALE AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RUSSELLS POINT
Mailing Address - State:OH
Mailing Address - Zip Code:43348-9311
Mailing Address - Country:US
Mailing Address - Phone:937-360-4561
Mailing Address - Fax:
Practice Address - Street 1:30 W MCCREIGHT AVE STE 100
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504
Practice Address - Country:US
Practice Address - Phone:937-399-3233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-12
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP 09938363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3127986Medicaid