Provider Demographics
NPI:1902481187
Name:REED, MICHELE RENEE (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:RENEE
Last Name:REED
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-2944
Mailing Address - Country:US
Mailing Address - Phone:724-413-4774
Mailing Address - Fax:
Practice Address - Street 1:111 ROBERTS RD
Practice Address - Street 2:
Practice Address - City:GRINDSTONE
Practice Address - State:PA
Practice Address - Zip Code:15442-2104
Practice Address - Country:US
Practice Address - Phone:724-785-4346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP023318363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health