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NPI Code Detail

MEDICARE: CHRISTINE ROSE REESOR FNP

MEDICARE: CHRISTINE ROSE REESOR FNP
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
1363LF0000XFamily Nurse PractitionerRN65566DC

General Provider Information

NPI Number : 1558457705
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE ROSE REESOR FNP
Provider Business Mailing Address
First Line : 6503 COCKERILLE AVE
Second Line :
City : TAKOMA PARK
State : MD
Zip : 20912-4733
Country : US
Telephone Number : 301-891-2985
Fax Number :
Provider Business Practice Location Address
First Line : 1618 MONROE ST NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20010-1804
Country : US
Telephone Number : 202-939-2413
Fax Number : 202-232-1970
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2006
Last Update Date : 07/08/2007

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