Provider Demographics
NPI:1306992680
Name:REED, LORRAINE MARIA (RN, CPNP)
Entity type:Individual
Prefix:MRS
First Name:LORRAINE
Middle Name:MARIA
Last Name:REED
Suffix:
Gender:F
Credentials:RN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3940 JANEL DR
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82604-5021
Mailing Address - Country:US
Mailing Address - Phone:307-473-2602
Mailing Address - Fax:
Practice Address - Street 1:350 N ASH ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-1808
Practice Address - Country:US
Practice Address - Phone:307-232-0159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics