Provider Demographics
NPI:1124827944
Name:REID, LORRAINE LETTICIA
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:LETTICIA
Last Name:REID
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1141 W OWENS AVE APT 205
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-1335
Mailing Address - Country:US
Mailing Address - Phone:728-202-3047
Mailing Address - Fax:
Practice Address - Street 1:1141 W OWENS AVE APT 205
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-1335
Practice Address - Country:US
Practice Address - Phone:728-202-3047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide