Basic Information
Provider Information
NPI: 1518917145
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: REED
FirstName: DIANNE
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: CNS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8450 NORTHWEST BLVD
Address2:  
City: INDIANAPOLIS
State: IN
PostalCode: 462781381
CountryCode: US
TelephoneNumber: 3178022000
FaxNumber: 3178022170
Practice Location
Address1: 8450 NORTHWEST BLVD
Address2:  
City: INDIANAPOLIS
State: IN
PostalCode: 462781381
CountryCode: US
TelephoneNumber: 3178022000
FaxNumber: 3178022170
Other Information
ProviderEnumerationDate: 05/12/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
364S00000X70000024AINY Physician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist 

No ID Information.


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