Provider Demographics
NPI:1043896095
Name:REED, LISA R
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:R
Last Name:REED
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 1:515 BLAIN LN
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45123-9668
Mailing Address - Country:US
Mailing Address - Phone:937-876-9701
Mailing Address - Fax:
Practice Address - Street 1:200 N 11TH ST APT 16
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:OH
Practice Address - Zip Code:45123-1268
Practice Address - Country:US
Practice Address - Phone:937-876-8327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-21
Last Update Date:2021-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker