Provider Demographics
NPI:1942850664
Name:REED, LENORA LEE
Entity Type:Individual
Prefix:MRS
First Name:LENORA
Middle Name:LEE
Last Name:REED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 TERMINAL ST
Mailing Address - Street 2:
Mailing Address - City:MOSHEIM
Mailing Address - State:TN
Mailing Address - Zip Code:37818-6205
Mailing Address - Country:US
Mailing Address - Phone:423-552-2684
Mailing Address - Fax:
Practice Address - Street 1:120 TERMINAL ST
Practice Address - Street 2:
Practice Address - City:MOSHEIM
Practice Address - State:TN
Practice Address - Zip Code:37818-6205
Practice Address - Country:US
Practice Address - Phone:423-552-2684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-14
Last Update Date:2019-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider