Healthcare Provider Details

I. General information

NPI: 1114359825
Provider Name (Legal Business Name): BRITTANY REEVES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2013
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14500 99TH AVE N
MAPLE GROVE MN
55369-4730
US

IV. Provider business mailing address

14500 99TH AVE N
MAPLE GROVE MN
55369-4730
US

V. Phone/Fax

Practice location:
  • Phone: 763-898-1820
  • Fax:
Mailing address:
  • Phone: 763-898-1820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number125930
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: