Provider Demographics
NPI:1629197231
Name:REID, CORA JANE (APRN)
Entity Type:Individual
Prefix:MS
First Name:CORA
Middle Name:JANE
Last Name:REID
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2907 SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-1993
Mailing Address - Country:US
Mailing Address - Phone:402-292-9001
Mailing Address - Fax:
Practice Address - Street 1:15345 W MAPLE RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-5186
Practice Address - Country:US
Practice Address - Phone:402-595-2180
Practice Address - Fax:402-595-1380
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110687363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily