Basic Information
Provider Information
NPI: 1417550559
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: REED
FirstName: LAUREN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3221 ARROW POINT DR
Address2:  
City: ZANESVILLE
State: OH
PostalCode: 437016983
CountryCode: US
TelephoneNumber: 7406072097
FaxNumber:  
Practice Location
Address1: 3814 JAMES CT
Address2:  
City: ZANESVILLE
State: OH
PostalCode: 437010965
CountryCode: US
TelephoneNumber: 7404547119
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/20/2020
LastUpdateDate: 11/20/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/20/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0200XAPRN.CNP.0027103OHY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics

No ID Information.


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