Provider Demographics
NPI:1528245503
Name:REED, CHARLOTTE ELISHA (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CHARLOTTE
Middle Name:ELISHA
Last Name:REED
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:283 FAIRVIEW ROAD
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT
Mailing Address - State:WV
Mailing Address - Zip Code:25550
Mailing Address - Country:US
Mailing Address - Phone:304-675-2008
Mailing Address - Fax:
Practice Address - Street 1:2520 VALLEY DR
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT
Practice Address - State:WV
Practice Address - Zip Code:25550-2031
Practice Address - Country:US
Practice Address - Phone:304-675-4340
Practice Address - Fax:304-675-4043
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-22
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV57804163W00000X, 364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
No163W00000XNursing Service ProvidersRegistered Nurse