Individual
LISA MARIE REID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
5364 BACHMAN RD, SHIPMAN, IL 62685-6005
(217) 419-1150
Mailing address
5364 BACHMAN RD, SHIPMAN, IL 62685-6005
(217) 419-1150
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209028772
IL
Other
Enumeration date
11/13/2023
Last updated
11/13/2023
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