Individual
ELLYN REID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1717 SHAFFER ST, KALAMAZOO, MI 49048-1647
(269) 552-0014
(269) 552-0016
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(269) 552-2823
(269) 552-2964
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704351071
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306731203
—
MI
Enumeration date
06/11/2025
Last updated
10/29/2025
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