Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC1500X | Nurse Practitioner - Community Health | OR | |
Y | 363LC1500X | Nurse Practitioner - Community Health | 000037688N2 PNP-PP | OR |
NPI | 1124065040 |
---|---|
Provider Name | Nancy Jane Reid |
First Address | Newport, OR 97365-3821 |
Second Address | Newport, OR 97365-3821 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 08/07/2007 |