Provider Demographics
NPI:1285987826
Name:REED, SANTASHIA DINETIRA (PMHNP)
Entity type:Individual
Prefix:MS
First Name:SANTASHIA
Middle Name:DINETIRA
Last Name:REED
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3618 FALLS TRL
Mailing Address - Street 2:
Mailing Address - City:WINSTON
Mailing Address - State:GA
Mailing Address - Zip Code:30187-1592
Mailing Address - Country:US
Mailing Address - Phone:585-576-5758
Mailing Address - Fax:
Practice Address - Street 1:3618 FALLS TRL
Practice Address - Street 2:
Practice Address - City:WINSTON
Practice Address - State:GA
Practice Address - Zip Code:30187-1592
Practice Address - Country:US
Practice Address - Phone:585-576-5758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-19
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN279624363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health