Provider Demographics
NPI:1699240010
Name:REID, SHANA-KAY
Entity type:Individual
Prefix:
First Name:SHANA-KAY
Middle Name:
Last Name:REID
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 1:271 MURRAY DR APT D
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-3439
Mailing Address - Country:US
Mailing Address - Phone:267-423-8154
Mailing Address - Fax:
Practice Address - Street 1:271 MURRAY DR APT D
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-3439
Practice Address - Country:US
Practice Address - Phone:267-423-8154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion