Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 229473 | AZ |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | SP024076 | PA |
NPI | 1023661386 |
---|---|
Provider Name | Mr. Austin Robert Reed |
First Address | Allentown, PA 18104-3008 |
Second Address | Center Valley, PA 18034-8476 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2019 |
Last Update Date | 27/09/2021 |