Provider Demographics
NPI:1891394821
Name:REED, MANDY LYNN (FNP-BC)
Entity type:Individual
Prefix:
First Name:MANDY
Middle Name:LYNN
Last Name:REED
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:MANDY
Other - Middle Name:LYNN
Other - Last Name:KWARSICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:1100 GOETHALS DR STE B
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-3301
Mailing Address - Country:US
Mailing Address - Phone:509-942-3062
Mailing Address - Fax:509-942-3085
Practice Address - Street 1:1100 GOETHALS DR STE B
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-3301
Practice Address - Country:US
Practice Address - Phone:509-942-3062
Practice Address - Fax:509-942-3085
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704293231163W00000X, 363LF0000X
MS904687363LF0000X
WAAP70015644363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse