Provider Demographics
NPI:1548880776
Name:REED, JANIE KAY (FNP)
Entity type:Individual
Prefix:MRS
First Name:JANIE
Middle Name:KAY
Last Name:REED
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:NA
Other - Middle Name:NA
Other - Last Name:NA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:477 HOUSTON RD
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-1181
Mailing Address - Country:US
Mailing Address - Phone:931-335-0175
Mailing Address - Fax:
Practice Address - Street 1:6263 POPLAR AVE STE 525
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-4753
Practice Address - Country:US
Practice Address - Phone:901-682-0430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-17
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26481363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNNAMedicaid