Provider Demographics
NPI:1033908132
Name:REED, TIMOTHY CLAYTON (RN)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:CLAYTON
Last Name:REED
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28886 N CARPENTER RD
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:IN
Mailing Address - Zip Code:46031-9736
Mailing Address - Country:US
Mailing Address - Phone:317-966-4472
Mailing Address - Fax:
Practice Address - Street 1:28886 N CARPENTER RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:IN
Practice Address - Zip Code:46031-9736
Practice Address - Country:US
Practice Address - Phone:317-966-4472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28201453A390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program