Basic Information
Provider Information
NPI: 1316596075
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: REED
FirstName: BRITTANI
MiddleName: ALESHA
NamePrefix: MRS.
NameSuffix:  
Credential: FNP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 3810
Address2:  
City: JOPLIN
State: MO
PostalCode: 648033810
CountryCode: US
TelephoneNumber: 4173474000
FaxNumber: 4173474064
Practice Location
Address1: 3415 MCINTOSH CIR
Address2:  
City: JOPLIN
State: MO
PostalCode: 648043651
CountryCode: US
TelephoneNumber: 4173474000
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/05/2019
LastUpdateDate: 09/06/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X2019034335MOY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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