Provider Demographics
NPI:1528868957
Name:REED, LONNIE K (CHW)
Entity type:Individual
Prefix:
First Name:LONNIE
Middle Name:K
Last Name:REED
Suffix:
Gender:M
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41022 N CONGRESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-1804
Mailing Address - Country:US
Mailing Address - Phone:480-487-1185
Mailing Address - Fax:
Practice Address - Street 1:1940 E THUNDERBIRD RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-5759
Practice Address - Country:US
Practice Address - Phone:480-487-1855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZCHW0000000445172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker