1285744839 NPI number — JUANA REED

Table of content: JUANA REED (NPI 1285744839)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285744839 NPI number — JUANA REED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REED
Provider First Name:
JUANA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285744839
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6291 POSSUM HOLLER RD SE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AGENCY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64401-9174
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-253-9152
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5506 CORPORATE DR
Provider Second Line Business Practice Location Address:
SUITE 1800
Provider Business Practice Location Address City Name:
SAINT JOSEPH
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64507-7752
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-232-9420
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2005005739 . This is a "LICENSE#" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




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