Individual
JAMIE LEE REIDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, PNP, WHNP
Contact information
Practice address
103 CENTENNIAL ST, SUITE B, LA PLATA, MD 20646-5984
(301) 643-8127
Mailing address
103 CENTENNIAL ST B, LA PLATA, MD 20646-5985
(301) 934-9111
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R162903
MD
363LW0102X
Women's Health Nurse Practitioner
R162903
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
033338700
—
MD
Enumeration date
05/31/2010
Last updated
08/27/2015
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