Provider Demographics
NPI:1184259384
Name:REED, ELLEN C (LPN, RN)
Entity type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:C
Last Name:REED
Suffix:
Gender:F
Credentials:LPN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 HERENDEEN RD
Mailing Address - Street 2:
Mailing Address - City:SHORTSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14548-9744
Mailing Address - Country:US
Mailing Address - Phone:585-245-2075
Mailing Address - Fax:
Practice Address - Street 1:6992 ROYCE CIR
Practice Address - Street 2:
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564-9554
Practice Address - Country:US
Practice Address - Phone:585-455-4527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-08
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY335803164W00000X
NY82954001163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse