Individual
AMANDA JANE REID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1019 MAJESTIC DR STE 210, LEXINGTON, KY 40513-1947
(859) 277-3114
(859) 277-0498
Mailing address
1019 MAJESTIC DR STE 210, LEXINGTON, KY 40513-1947
(859) 277-3114
(859) 277-0498
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3013222
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0345677
—
OH
05
—
7100608490
—
KY
01
—
K292470
MEDICARE PTAN
KY
01
—
K292471
MEDICARE PTAN
KY
Enumeration date
03/21/2019
Last updated
06/17/2025
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