Healthcare Provider Details

I. General information

NPI: 1114594645
Provider Name (Legal Business Name): NOAH SCOTT REID APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2021
Last Update Date: 02/25/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 ORCHARD ST
ONEIDA KY
40972-6409
US

IV. Provider business mailing address

11217 HIGHWAY 421 S
TYNER KY
40486-8352
US

V. Phone/Fax

Practice location:
  • Phone: 606-847-4000
  • Fax: 606-847-9331
Mailing address:
  • Phone: 606-598-5104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3016201
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: