Individual
JAKEYLA REED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
163411
IA
363LA2100X
Acute Care Nurse Practitioner
163411
IA
363LA2100X
Acute Care Nurse Practitioner
Primary
277001004
IL
363LA2200X
Adult Health Nurse Practitioner
277001004
IL
363LG0600X
Gerontology Nurse Practitioner
163411
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277001004
—
IL
Enumeration date
02/01/2019
Last updated
06/30/2023
Update your record
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