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General NPI Number Information
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NPI Number | 1578996740
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Entity Type | Individual
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Provider Name | REVA GAY REESE FNP
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Gender | Female
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Dates
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Enumeration Date | 08/12/2013
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 701 HOSPITAL LOOP
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City | FAIRCHILD AFB
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State | WA
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Zip | 99011-8704
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Country | US
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Telephone | 509-247-5661
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Fax | 509-247-9524
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Provider Business Mailing Address
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Address Line | 701 HOSPITAL LOOP
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City | FAIRCHILD AFB
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State | WA
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Zip | 99011-8704
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Country | US
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Telephone | 509-247-5661
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Fax | 509-247-9524
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP-1251A
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP60331559
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License Number State | WA
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