Provider Demographics
NPI:1700224979
Name:REED, TANYA SIMONE (MSN, FNP-C, MPH)
Entity Type:Individual
Prefix:MS
First Name:TANYA
Middle Name:SIMONE
Last Name:REED
Suffix:
Gender:F
Credentials:MSN, FNP-C, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 W PARKER RD STE 322
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8103
Mailing Address - Country:US
Mailing Address - Phone:972-939-8294
Mailing Address - Fax:214-731-0240
Practice Address - Street 1:6300 W PARKER RD STE 322
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8103
Practice Address - Country:US
Practice Address - Phone:972-939-8294
Practice Address - Fax:214-731-0240
Is Sole Proprietor?:No
Enumeration Date:2013-06-11
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP123728363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX337564401Medicaid
TX337564401Medicaid