Provider Demographics
NPI:1760169924
Name:READER, JESSICA LEE (CMNT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LEE
Last Name:READER
Suffix:
Gender:F
Credentials:CMNT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 MORNING MIST LN
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29680-7329
Mailing Address - Country:US
Mailing Address - Phone:720-979-8844
Mailing Address - Fax:
Practice Address - Street 1:707 MORNING MIST LN
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29680-7329
Practice Address - Country:US
Practice Address - Phone:720-979-8844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center