Individual ProviderLatasha ReidNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address8019 Dixie Hwy Ste 101, Louisville, KY 40258-1303(502) 333-3121PECOS EnrollmentBased on the most recent information from CMS, provider Latasha Reid is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1992210165Provider TypeIndividualFull NameReid, LatashaGenderFemaleSole ProprietorNoEnumeration Date12/8/2017Last Updated8/15/2023Contact InformationPractice LocationPractice Address8019 Dixie Hwy Ste 101, Louisville, KY 40258-1303Phone(502) 333-3121Fax(502) 531-9538Mailing LocationMailing Address8019 Dixie Hwy Ste 101, Louisville, KY 40258-1303Phone(502) 333-3121Fax(502) 531-9538Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense3012355KentuckyCode163W00000XDescriptionRegistered NurseNursing Service ProvidersLicense112721Kentucky