Healthcare Provider Details

I. General information

NPI: 1588956809
Provider Name (Legal Business Name): TASHIKA BESWICK REEVES CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2011
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 MIDDLETOWN BLVD SUITE 205
LANGHORNE PA
19047-1904
US

IV. Provider business mailing address

240 MIDDLETOWN BLVD 2ND FL STE 205
LANGHORNE PA
19047-1904
US

V. Phone/Fax

Practice location:
  • Phone: 215-752-2424
  • Fax: 215-750-0656
Mailing address:
  • Phone: 215-752-2424
  • Fax: 215-750-0656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP011359
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberSP011359
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: