Provider Demographics
NPI:1770804049
Name:REED, TALYA M (MSN/APN)
Entity type:Individual
Prefix:
First Name:TALYA
Middle Name:M
Last Name:REED
Suffix:
Gender:F
Credentials:MSN/APN
Other - Prefix:
Other - First Name:TALYA
Other - Middle Name:M
Other - Last Name:CODY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSN/APN
Mailing Address - Street 1:4430 MISSOURI AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LEONARD WOOD
Mailing Address - State:MO
Mailing Address - Zip Code:65473-9098
Mailing Address - Country:US
Mailing Address - Phone:573-596-1765
Mailing Address - Fax:
Practice Address - Street 1:4430 MISSOURI AVE
Practice Address - Street 2:
Practice Address - City:FORT LEONARD WOOD
Practice Address - State:MO
Practice Address - Zip Code:65473-9098
Practice Address - Country:US
Practice Address - Phone:573-596-1765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010019831363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily