Provider Demographics
NPI:1154101210
Name:REID, LOVINE KERRON (CNA)
Entity type:Individual
Prefix:
First Name:LOVINE
Middle Name:KERRON
Last Name:REID
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 POND CIR
Mailing Address - Street 2:
Mailing Address - City:FORESTDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02644-1647
Mailing Address - Country:US
Mailing Address - Phone:774-368-4797
Mailing Address - Fax:
Practice Address - Street 1:19000 OAK RD W
Practice Address - Street 2:
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542-5662
Practice Address - Country:US
Practice Address - Phone:774-368-4797
Practice Address - Fax:774-521-3746
Is Sole Proprietor?:No
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide