Provider Demographics
NPI:1104173806
Name:REED, TRENTON ANDREW
Entity type:Individual
Prefix:MR
First Name:TRENTON
Middle Name:ANDREW
Last Name:REED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15374 COUNTY ROAD T
Mailing Address - Street 2:
Mailing Address - City:NAPOLEON
Mailing Address - State:OH
Mailing Address - Zip Code:43545-9758
Mailing Address - Country:US
Mailing Address - Phone:419-966-0841
Mailing Address - Fax:
Practice Address - Street 1:15374 COUNTY ROAD T
Practice Address - Street 2:
Practice Address - City:NAPOLEON
Practice Address - State:OH
Practice Address - Zip Code:43545-9758
Practice Address - Country:US
Practice Address - Phone:419-966-0841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-13
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CRNA.13993367500000X
CA723803163W00000X
OHCOA.13993-NA207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology