Provider Demographics
NPI:1700206414
Name:REEDY, JOSEPH (RN)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:REEDY
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 612
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154-0612
Mailing Address - Country:US
Mailing Address - Phone:469-383-9909
Mailing Address - Fax:972-923-1353
Practice Address - Street 1:664 BROOKCREST CT
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-6142
Practice Address - Country:US
Practice Address - Phone:469-383-9909
Practice Address - Fax:972-923-1353
Is Sole Proprietor?:No
Enumeration Date:2014-04-21
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX659743163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health