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General NPI Number Information
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NPI Number | 1184473910
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Entity Type | Individual
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Provider Name | ANDRE ROMEL REESE APRN
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Gender | Male
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Dates
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Enumeration Date | 05/14/2024
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 4530 S EASTERN AVE STE 1
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City | LAS VEGAS
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State | NV
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Zip | 89119-6181
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Country | US
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Telephone | 912-373-3391
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Fax |
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Provider Business Mailing Address
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Address Line | 1050 E FLAMINGO RD STE 107
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City | LAS VEGAS
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State | NV
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Zip | 89119-7429
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Country | US
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Telephone | 702-996-1517
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Fax | 702-996-1517
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 879050
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License Number State | NV
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