Provider Demographics
NPI:1487824728
Name:REID, GLORIA KOO (NP)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:KOO
Last Name:REID
Suffix:
Gender:F
Credentials:NP
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Other - Credentials:
Mailing Address - Street 1:ICHP 8901 WISCONSIN AVE
Mailing Address - Street 2:BUILDING 17, SUITE 2A
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-5600
Mailing Address - Country:US
Mailing Address - Phone:301-400-1111
Mailing Address - Fax:301-400-1620
Practice Address - Street 1:ICHP 8901 WISCONSIN AVE
Practice Address - Street 2:BUILDING 17, SUITE 2A
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-5600
Practice Address - Country:US
Practice Address - Phone:301-400-1111
Practice Address - Fax:301-400-1620
Is Sole Proprietor?:No
Enumeration Date:2008-03-03
Last Update Date:2013-12-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDR168950363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care