Provider Demographics
NPI:1124423892
Name:REED, GEOLINA LEWISE
Entity type:Individual
Prefix:
First Name:GEOLINA
Middle Name:LEWISE
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:PO BOX 24
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02724-0024
Mailing Address - Country:US
Mailing Address - Phone:508-345-3730
Mailing Address - Fax:
Practice Address - Street 1:91 STAR ST
Practice Address - Street 2:APT 3
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02724-3018
Practice Address - Country:US
Practice Address - Phone:508-345-3730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747P1801X, 374U00000X
MA253566376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide