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NPI Code Detail

MEDICARE: STEPHANIE REESE RN

MEDICARE: STEPHANIE REESE RN
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
1163W00000XRegistered Nurse2011002983MO

General Provider Information

NPI Number : 1700203932
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE REESE RN
Provider Business Mailing Address
First Line : PO BOX 429
Second Line : 20 NORTH GRAND
City : SALEM
State : MO
Zip : 65560-1833
Country : US
Telephone Number : 573-729-4103
Fax Number : 573-729-4420
Provider Business Practice Location Address
First Line : 203 N GRAND ST
Second Line :
City : SALEM
State : MO
Zip : 65560-1344
Country : US
Telephone Number : 573-729-4103
Fax Number : 573-729-4420
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2014
Last Update Date : 03/26/2014

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