Healthcare Provider Details

I. General information

NPI: 1114598174
Provider Name (Legal Business Name): KARLA J. REEVES CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2021
Last Update Date: 05/17/2022
Certification Date: 05/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2350 MIAMI VALLEY DR STE 500
CENTERVILLE OH
45459-4780
US

IV. Provider business mailing address

1022 HOLLANSBURG ARCANUM RD
HOLLANSBURG OH
45332-9715
US

V. Phone/Fax

Practice location:
  • Phone: 937-293-1622
  • Fax: 937-245-6308
Mailing address:
  • Phone: 937-564-5082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0029233
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: