MEDICARE: CARI LEE REESE APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN00141403	WA
2	363LA2100X	Acute Care Nurse Practitioner	AP30007511	WA
3	363L00000X	Nurse Practitioner	APRN001249	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12183148	OTHER		CAQH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356417083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARI LEE REESE APRN

Provider Business Mailing Address
First Line	:	640 W MOANA LN
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89509-4903
Country	:	US
Telephone Number	:	775-324-0699
Fax Number	:	775-323-6814

Provider Business Practice Location Address
First Line	:	1075 N HILLS BLVD
Second Line	:	#180
City	:	RENO
State	:	NV
Zip	:	89506-5732
Country	:	US
Telephone Number	:	775-982-5000
Fax Number	:	775-982-6558

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/27/2006
Last Update Date	:	11/07/2018

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Directions to “ CARI LEE REESE APRN” Practice Location

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