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Individual

LEIGHA MAKENZIE REID

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
510 BUTLER AVE, MARTINSBURG, WV 25405-9990
(304) 263-0811
Mailing address
22 MCGILL DR, GERRARDSTOWN, WV 25420-4028
(304) 268-4204

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
32897
WV
164W00000X
Licensed Practical Nurse
Primary
52319
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R60744812
BLUECROSS BLUESHIELD
Enumeration date
10/25/2017
Last updated
10/25/2017
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