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Individual
TIFFANY N REID
Active
Individual
TIFFANY N REID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
10001296A
IN
363AS0400X
Surgical Physician Assistant
10001296A
IN
363AS0400X
Surgical Physician Assistant
Primary
PA1644
KY
363AS0400X
Surgical Physician Assistant
TC024
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K021770
MEDICARE PTAN- NORTON CTS
KY
Enumeration date
08/03/2011
Last updated
11/07/2025
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