Provider Demographics
NPI:1720420961
Name:REED, KRISTIN ANN (OD, FAAO)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:ANN
Last Name:REED
Suffix:
Gender:F
Credentials:OD, FAAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19060 Q ST STE 107
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135-1504
Mailing Address - Country:US
Mailing Address - Phone:028-073-9374
Mailing Address - Fax:402-807-7255
Practice Address - Street 1:19060 Q ST
Practice Address - Street 2:STE 107
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68135-1504
Practice Address - Country:US
Practice Address - Phone:402-431-1203
Practice Address - Fax:402-431-4960
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-29
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1398152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist