Individual
JEANNE REED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
52 HAZELNUT HILL RD, GROTON, CT 06340
(860) 446-8265
Mailing address
4 KING JAMES DR, EAST LYME, CT 06333-1016
(860) 420-7706
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001631
CT
363A00000X
Physician Assistant
1631
CT
363A00000X
Physician Assistant
MA052071
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1631
STATE LICENSE
CT
Enumeration date
03/15/2007
Last updated
11/26/2019
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