Provider Demographics
NPI:1972850865
Name:REED, CODY (LPN)
Entity type:Individual
Prefix:
First Name:CODY
Middle Name:
Last Name:REED
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 SHAY ST
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-5025
Mailing Address - Country:US
Mailing Address - Phone:740-358-2783
Mailing Address - Fax:
Practice Address - Street 1:134 SHAY ST
Practice Address - Street 2:134 SHAY ST.
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-5025
Practice Address - Country:US
Practice Address - Phone:740-358-2783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH146791-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse