MEDICARE: AMANDA JANE REID NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	3013222	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	K292471	OTHER	KY	MEDICARE PTAN
4	K292470	OTHER	KY	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003376609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA JANE REID NP

Provider Business Mailing Address
First Line	:	1019 MAJESTIC DR STE 210
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40513-1947
Country	:	US
Telephone Number	:	859-277-3114
Fax Number	:	859-277-0498

Provider Business Practice Location Address
First Line	:	1019 MAJESTIC DR STE 210
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40513-1947
Country	:	US
Telephone Number	:	859-277-3114
Fax Number	:	859-277-0498

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2019
Last Update Date	:	06/17/2025

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Directions to “ AMANDA JANE REID NP” Practice Location

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