Provider Demographics
NPI:1578218657
Name:REED, DONECA SHESA
Entity Type:Individual
Prefix:
First Name:DONECA
Middle Name:SHESA
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 1:22149 CENTURY DR
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-4765
Mailing Address - Country:US
Mailing Address - Phone:248-386-6260
Mailing Address - Fax:
Practice Address - Street 1:22149 CENTURY DRIVE
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:FM
Practice Address - Zip Code:48180
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide