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NPI Code Detail

MEDICARE: MARY MARGARET REESE MSN

MEDICARE: MARY MARGARET REESE MSN
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 PractitionerR1457335MN

General Provider Information

NPI Number : 1851385470
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY MARGARET REESE MSN
Provider Business Mailing Address
First Line : 5605 SYCAMORE LN N
Second Line :
City : PLYMOUTH
State : MN
Zip : 55442-1418
Country : US
Telephone Number : 763-383-8864
Fax Number :
Provider Business Practice Location Address
First Line : 900 NICOLLET MALL
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55403-2530
Country : US
Telephone Number : 612-659-7111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2005
Last Update Date : 07/08/2007

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