Basic Information
Provider Information
NPI: 1790226272
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: REED
FirstName: KARIN
MiddleName: O.
NamePrefix:  
NameSuffix:  
Credential: FNP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 470408
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282470408
CountryCode: US
TelephoneNumber: 7043750100
FaxNumber: 7043353592
Practice Location
Address1: 7845 LITTLE AVE
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 28226
CountryCode: US
TelephoneNumber: 7043750100
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/16/2017
LastUpdateDate: 06/10/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X261598NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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