Provider Demographics
NPI:1538566815
Name:REED, EVELYN
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:REED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:REIDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27320-5819
Mailing Address - Country:US
Mailing Address - Phone:336-349-6771
Mailing Address - Fax:
Practice Address - Street 1:405 NC HWY 65
Practice Address - Street 2:
Practice Address - City:WENTWORTH
Practice Address - State:NC
Practice Address - Zip Code:27375
Practice Address - Country:US
Practice Address - Phone:336-342-8316
Practice Address - Fax:336-342-8330
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-02
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC81332163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse