Provider Demographics
NPI:1417679168
Name:REED, PAIGE (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:REED
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1123 1ST AVE E STE 200
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:IA
Mailing Address - Zip Code:50208-3981
Mailing Address - Country:US
Mailing Address - Phone:641-792-4012
Mailing Address - Fax:
Practice Address - Street 1:1123 1ST AVE E STE 200
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:IA
Practice Address - Zip Code:50208-3981
Practice Address - Country:US
Practice Address - Phone:641-792-4012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA152156163W00000X
IAG171286363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse