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
Health care specialties
Specialty | Code | License # | 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 13 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1710937073 | NPPES |
Missouri | MEDICAID | 815032931 | |
Missouri | MEDICAID | 427399902 | |
Missouri | Other | 1710937073 | |
Missouri | Other | 11646789 |
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