Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 45439 | KS |
NPI | 1003882101 |
---|---|
Provider Name | Ms. Melanie J Reed |
First Address | Kansas City, KS 66112 |
Second Address | Kansas City, KS 66112 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2006 |
Last Update Date | 09/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200262860 | (05) | KS |
Q26088 | (02) |