Provider Demographics
NPI:1669551388
Name:REEDER, LAURIE L (RXN, NP)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:L
Last Name:REEDER
Suffix:
Gender:F
Credentials:RXN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19753 E PIKES PEAK AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-7435
Mailing Address - Country:US
Mailing Address - Phone:720-542-3487
Mailing Address - Fax:720-542-3566
Practice Address - Street 1:19753 E PIKES PEAK AVE STE 202
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-7435
Practice Address - Country:US
Practice Address - Phone:720-542-3487
Practice Address - Fax:720-542-3566
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO74231363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
COMR1283732OtherDEA