Healthcare Provider Details
I. General information
NPI: 1083549117
Provider Name (Legal Business Name): HALEY REEVES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
830 S GLOSTER ST
TUPELO MS
38801-4934
US
IV. Provider business mailing address
3329 RIVERBEND RD
BELDEN MS
38826-1003
US
V. Phone/Fax
- Phone: 662-377-3000
- Fax:
- Phone: 662-415-4081
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WC0200X |
| Taxonomy | Critical Care Medicine Registered Nurse |
| License Number | 906654 |
| License Number State | MS |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: