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NPI Code Detail

MEDICARE: KELLEY MOORE REAVES

MEDICARE: KELLEY MOORE REAVES
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
1363LF0000XFamily Nurse Practitioner1-167473AL

General Provider Information

NPI Number : 1750184313
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLEY MOORE REAVES
Provider Business Mailing Address
First Line : 1600 7TH AVE S
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35233-1711
Country : US
Telephone Number : 205-638-9050
Fax Number : 205-638-2889
Provider Business Practice Location Address
First Line : 1600 7TH AVE S
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35233-1711
Country : US
Telephone Number : 205-638-9050
Fax Number : 205-638-2889
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2025
Last Update Date : 06/10/2026

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Directions to “ KELLEY MOORE REAVES ” Practice Location

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