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Individual

MRS. LISA MAE REEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP, RN

Contact information

Practice address
803 S MAIN ST, WOODSTOCK, VA 22664-1125
(540) 345-3556
(540) 342-2193
Mailing address
PO BOX 8310, ROANOKE, VA 24014-0310
(540) 345-3556
(540) 342-2193

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024168130
VA
363LG0600X
Gerontology Nurse Practitioner
2008005676
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P01695331
RR MEDICARE
VA
Enumeration date
12/09/2008
Last updated
07/25/2022
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