| Doctor Name: | MRS. KELLY DAWN REID |
| NPI Number: | 1407992795 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 130624 |
| Business Practice Address: | 1708 Spruce Dr High Ridge, MO - 630491867 |
| Business Phone Number: | 6366776744 |
| Business Fax Number: | |
| Mailing Address: | 1708 Spruce Dr, HIGH RIDGE |
| State: | MO |
| Postal Code: | 630491867 |
| Phone Number: | 6366776744 |
| Fax Number: | |
| NPI Enumeration Date: | 01/30/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WA2000X |
| License Number: | 130624 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | MO |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Administrator |
| Taxonomy Definition: | |