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Individual

MRS. LAURA REEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 997-5311
Mailing address
2401 WEST MAIN ST., MARION, IL 62549
(618) 997-5311

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1103605
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
74008582
KY
Enumeration date
09/27/2006
Last updated
01/26/2017
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