Provider Demographics
NPI:1629674312
Name:REED, CHRISTA (FNP-C)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:
Last Name:REED
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5707 SAGEBRUSH TRL
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-1116
Mailing Address - Country:US
Mailing Address - Phone:817-366-8292
Mailing Address - Fax:
Practice Address - Street 1:4118 FIRSTVIEW DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3915
Practice Address - Country:US
Practice Address - Phone:817-366-8292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61084529363L00000X
CA95015518363L00000X
NV832139363L00000X
TX1002205363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner