Provider Demographics
NPI:1457107690
Name:REED, TONI ROCHELLE (RN BSN)
Entity type:Individual
Prefix:MRS
First Name:TONI
Middle Name:ROCHELLE
Last Name:REED
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:TONI
Other - Middle Name:ROCHELLE
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4201 AZALEA ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87402-1751
Mailing Address - Country:US
Mailing Address - Phone:505-947-7335
Mailing Address - Fax:
Practice Address - Street 1:2502 MARBLE AVE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:800-690-0934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program