Provider Demographics
NPI:1700684958
Name:TINNIE, KEBBEH REED (RN)
Entity type:Individual
Prefix:
First Name:KEBBEH
Middle Name:REED
Last Name:TINNIE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KEBBEH
Other - Middle Name:
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3725 18TH ST S
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-2994
Mailing Address - Country:US
Mailing Address - Phone:701-566-1664
Mailing Address - Fax:
Practice Address - Street 1:501 MAIN AVE STE A
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-2769
Practice Address - Country:US
Practice Address - Phone:701-566-1664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2526527163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health