Provider Demographics
NPI:1184458523
Name:REIDHEAD, SCOTTIA RAE
Entity type:Individual
Prefix:
First Name:SCOTTIA
Middle Name:RAE
Last Name:REIDHEAD
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 1:3901 W LINDA VISTA BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-9566
Mailing Address - Country:US
Mailing Address - Phone:520-579-4421
Mailing Address - Fax:520-579-4469
Practice Address - Street 1:3901 W LINDA VISTA BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85742-9566
Practice Address - Country:US
Practice Address - Phone:520-579-4421
Practice Address - Fax:520-579-4469
Is Sole Proprietor?:No
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN103926163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool