Healthcare Provider Details

I. General information

NPI: 1740669332
Provider Name (Legal Business Name): TROY S REEVES FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2015
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 HAYES AVENUE
SANDUSKY OH
44870
US

IV. Provider business mailing address

1111 HAYES AVENUE
SANDUSKY OH
44870-3323
US

V. Phone/Fax

Practice location:
  • Phone: 419-557-7400
  • Fax: 419-557-7782
Mailing address:
  • Phone: 419-557-7455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11001406
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704341774
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number343842
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.17371-NP
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number17371-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: