Provider Demographics
NPI:1578054219
Name:REED, RHONDA JEAN
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:JEAN
Last Name:REED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1446 BLACKHURST DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63137-1531
Mailing Address - Country:US
Mailing Address - Phone:314-337-4982
Mailing Address - Fax:314-395-0194
Practice Address - Street 1:1446 BLACKHURST DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63137-1531
Practice Address - Country:US
Practice Address - Phone:314-337-4982
Practice Address - Fax:314-395-0194
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO343900000XMedicaid