Individual
SALLY W REEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1016 E SPRING ST, MONROE, GA 30655-2469
(770) 464-0280
(770) 464-0233
Mailing address
1016 E SPRING ST, MONROE, GA 30655-2469
(770) 464-0280
(770) 464-0233
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
RN124766
GA
363AM0700X
Medical Physician Assistant
RN124766
GA
363L00000X
Nurse Practitioner
Primary
RN124766
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000915307
—
GA
05
—
000915307I
—
GA
05
—
000915307J
—
GA
01
—
10044973
AMERIGROUP
GA
01
—
333436
WELLCARE OF GEORGIA
GA
Enumeration date
05/20/2006
Last updated
02/20/2025
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