Healthcare Provider Details

I. General information

NPI: 1801374913
Provider Name (Legal Business Name): EMMA REEVE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2018
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9336 E RAINTREE DR STE 150
SCOTTSDALE AZ
85260-7314
US

IV. Provider business mailing address

4840 W GERONIMO ST
CHANDLER AZ
85226-5314
US

V. Phone/Fax

Practice location:
  • Phone: 480-219-5597
  • Fax: 480-219-5547
Mailing address:
  • Phone: 480-232-1937
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number7145
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: