Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | RN175387 | GA |
NPI | 1023240850 |
---|---|
Provider Name | Mrs. Melissa Nichole Reed |
First Address | Minnetonka, MN 55343-9664 |
Second Address | Minnetonka, MN 55343 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2009 |
Last Update Date | 23/09/2020 |