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General NPI Number Information
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NPI Number | 1679783567
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Entity Type | Individual
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Provider Name | JAMI LYNN REAVES DO
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Gender | Female
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 04/17/2013
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Provider Practice Location Address
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Address Line | 8 SHERIDAN SQ STE 110
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City | KINGSPORT
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State | TN
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Zip | 37660-7478
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Country | US
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Telephone | 423-408-1508
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Fax | 423-218-0138
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Provider Business Mailing Address
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Address Line | 8 SHERIDAN SQ STE 110
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City | KINGSPORT
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State | TN
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Zip | 37660-7478
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Country | US
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Telephone | 423-408-1508
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Fax | 423-218-0138
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 4371
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | DO2262
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License Number State | TN
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