Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 95005675 | CA |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | APRN002037 | NV |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | ARNP9377302 | FL |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | CNP01036 | NM |
NPI | 1164852786 |
---|---|
Provider Name | Ila Evette Reed |
First Address | San Diego, CA 92101-2258 |
Second Address | San Diego, CA 92123-4223 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2013 |
Last Update Date | 04/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003151317A | (05) | GA |
010949200 | (05) | FL |