MEDICARE: SARAH ELIZABETH REEVES FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	2022039870	MO

General Provider Information

NPI Number	:	1285342899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH ELIZABETH REEVES FNP-C

Provider Business Mailing Address
First Line	:	2700 FORUM BLVD
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65203-5433
Country	:	US
Telephone Number	:	573-397-8898
Fax Number	:

Provider Business Practice Location Address
First Line	:	2700 FORUM BLVD
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65203-5433
Country	:	US
Telephone Number	:	573-397-8898
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/11/2022
Last Update Date	:	10/04/2024

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