Provider Demographics
NPI:1871273466
Name:REEDY, JAMIE
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:REEDY
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 1:2502 MARTIN LUTHER KING BLVD E
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48601-7454
Mailing Address - Country:US
Mailing Address - Phone:469-499-6523
Mailing Address - Fax:
Practice Address - Street 1:2502 MARTIN LUTHER KING BLVD E
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48601-7454
Practice Address - Country:US
Practice Address - Phone:469-499-6523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health