Blake Reeves, Mary L

Blake Reeves, Mary L is an individual health care provider with primary practice located at 4626 Lee Ave , Saint Louis MO 63115-2431. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Blake Reeves, Mary L can be contacted via phone (314) 385-7726.

Contact Information

Primary practice address
4626 Lee Ave Saint Louis MO 63115-2431
Phone: (314) 385-7726
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 068911 Missouri

Profile Details

NPI number 1710937073
LBN Legal business name Blake Reeves, Mary L
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2006
Last updated Sep 19th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710937073 NPPES
Missouri MEDICAID 815032931
Missouri MEDICAID 427399902
Missouri Other 1710937073
Missouri Other 11646789

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