Provider Demographics
NPI:1063982932
Name:REED, LORI
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
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 1:8225 RUSSELLVILLE WINCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45168-9728
Mailing Address - Country:US
Mailing Address - Phone:937-515-9252
Mailing Address - Fax:
Practice Address - Street 1:8225 RUSSELLVILLE WINCHESTER RD
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:OH
Practice Address - Zip Code:45168-9728
Practice Address - Country:US
Practice Address - Phone:937-515-9252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-04
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.075396164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse