Provider Demographics
NPI:1285402958
Name:REID, ASHLEE SHIANN (WHNP, MSN, RN)
Entity type:Individual
Prefix:MS
First Name:ASHLEE
Middle Name:SHIANN
Last Name:REID
Suffix:
Gender:F
Credentials:WHNP, MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 E 52ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-5311
Mailing Address - Country:US
Mailing Address - Phone:929-225-5734
Mailing Address - Fax:
Practice Address - Street 1:1412 BROADWAY STE 2128
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-9228
Practice Address - Country:US
Practice Address - Phone:718-615-0049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-13
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY421786363LW0102X
NY829539163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse