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General NPI Number Information
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NPI Number | 1962295212
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Entity Type | Individual
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Provider Name | TRISTEN RENEA REESOR APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 05/28/2025
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 234 EASTBROOKE PKWY
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City | MOUNT WASHINGTON
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State | KY
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Zip | 40047-5600
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Country | US
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Telephone | 502-538-3050
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 932958
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City | CLEVELAND
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State | OH
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Zip | 44193-0028
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Country | US
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Telephone |
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Fax |
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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 | 4040856
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License Number State | KY
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