Provider Demographics
NPI:1902036999
Name:REED, JANICE DENISE (CNP)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:DENISE
Last Name:REED
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 VALLEY ST STE 200
Mailing Address - Street 2:
Mailing Address - City:BALL GROUND
Mailing Address - State:GA
Mailing Address - Zip Code:30107-4068
Mailing Address - Country:US
Mailing Address - Phone:770-737-2770
Mailing Address - Fax:770-737-2406
Practice Address - Street 1:470 VALLEY ST STE 200
Practice Address - Street 2:
Practice Address - City:BALL GROUND
Practice Address - State:GA
Practice Address - Zip Code:30107-4068
Practice Address - Country:US
Practice Address - Phone:770-737-2770
Practice Address - Fax:770-737-2406
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN129274363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003105959IMedicaid
GA003105959LMedicaid
GA003105959LMedicaid