Provider Demographics
NPI:1023201902
Name:FLANNERY REEVES, KATHERINE E (ARNP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:E
Last Name:FLANNERY REEVES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 MANATEE LN
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-3662
Mailing Address - Country:US
Mailing Address - Phone:513-265-7833
Mailing Address - Fax:
Practice Address - Street 1:5870 HIATUS RD
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-6424
Practice Address - Country:US
Practice Address - Phone:800-424-3672
Practice Address - Fax:954-377-3042
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3005212363LF0000X
OH2007001906363LA2100X
FL11003295363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily