Provider Demographics
NPI:1588161764
Name:REED, LYNN MICHELLE
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:MICHELLE
Last Name:REED
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 1:40309 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-2072
Mailing Address - Country:US
Mailing Address - Phone:248-479-7811
Mailing Address - Fax:248-536-2642
Practice Address - Street 1:15520 LEXINGTON
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-3913
Practice Address - Country:US
Practice Address - Phone:313-533-5419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-12
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704203803163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health