Provider Demographics
NPI:1427493154
Name:REEDY, RITA CAROL
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:CAROL
Last Name:REEDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 PHYLLIS PLACE
Mailing Address - Street 2:
Mailing Address - City:HARVEYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45032
Mailing Address - Country:US
Mailing Address - Phone:412-689-1601
Mailing Address - Fax:
Practice Address - Street 1:15 PHYLLIS PLACE
Practice Address - Street 2:
Practice Address - City:HARVEYSBURG
Practice Address - State:OH
Practice Address - Zip Code:45032
Practice Address - Country:US
Practice Address - Phone:412-689-1601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH120796164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse