Provider Demographics
NPI:1316245160
Name:REED, AUDREY S
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:S
Last Name:REED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AUDREY
Other - Middle Name:S
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:11148 REED RD
Mailing Address - Street 2:
Mailing Address - City:HOWEY IN THE HILLS
Mailing Address - State:FL
Mailing Address - Zip Code:34737-4220
Mailing Address - Country:US
Mailing Address - Phone:352-324-3016
Mailing Address - Fax:
Practice Address - Street 1:11148 REED RD
Practice Address - Street 2:
Practice Address - City:HOWEY IN THE HILLS
Practice Address - State:FL
Practice Address - Zip Code:34737-4220
Practice Address - Country:US
Practice Address - Phone:352-324-3016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1353762163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse