Provider Demographics
NPI:1497729644
Name:REED, BETTINA LONGEST (FNP)
Entity Type:Individual
Prefix:MRS
First Name:BETTINA
Middle Name:LONGEST
Last Name:REED
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11814 KING WILLIAM RD
Mailing Address - Street 2:PO BOX 213
Mailing Address - City:AYLETT
Mailing Address - State:VA
Mailing Address - Zip Code:23009-4103
Mailing Address - Country:US
Mailing Address - Phone:804-769-3022
Mailing Address - Fax:804-769-1253
Practice Address - Street 1:901 EAST CARY STREET
Practice Address - Street 2:SUITE 1605
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219
Practice Address - Country:US
Practice Address - Phone:804-697-2999
Practice Address - Fax:833-661-1971
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001129427163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA500000297Medicare ID - Type Unspecified