Basic Information
Provider Information
NPI: 1720038565
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: REED
FirstName: ROB
MiddleName: ROY
NamePrefix:  
NameSuffix:  
Credential: C.R.N.A.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 843966 PO BOX 840
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641843966
CountryCode: US
TelephoneNumber: 5738843300
FaxNumber: 5738840943
Practice Location
Address1: 1 HOSPITAL DR
Address2:  
City: COLUMBIA
State: MO
PostalCode: 652121000
CountryCode: US
TelephoneNumber: 5738822568
FaxNumber: 5738822226
Other Information
ProviderEnumerationDate: 05/11/2006
LastUpdateDate: 09/12/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/18/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X149947MOY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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