Provider Demographics
NPI:1881695005
Name:REED, CAROL JEAN (ANP)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:JEAN
Last Name:REED
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4906 WHITE HORSE DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-9547
Mailing Address - Country:US
Mailing Address - Phone:336-580-2399
Mailing Address - Fax:
Practice Address - Street 1:GRAY DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27402
Practice Address - Country:US
Practice Address - Phone:336-334-3141
Practice Address - Fax:336-334-5343
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC900085363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health