Doctor Name: | JODY P REEVES |
NPI Number: | 1306273693 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ANP-BC |
License Number: | 279282 |
Business Practice Address: | 100 Rosebrook Way 2nd Floor Wareham, MA - 025711138 |
Business Phone Number: | 5082734950 |
Business Fax Number: | 5082794951 |
Mailing Address: | 200 Mill Rd, Suite 180 FAIRHAVEN |
State: | MA |
Postal Code: | 027195252 |
Phone Number: | 5089732000 |
Fax Number: | 5089732001 |
NPI Enumeration Date: | 10/01/2013 |
NPI Last Update Date: | 10/01/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 279282 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |