Provider Demographics
NPI:1023551595
Name:REESE, LARINDA MARIE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:LARINDA
Middle Name:MARIE
Last Name:REESE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 N MELROSE ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-2735
Mailing Address - Country:US
Mailing Address - Phone:307-234-6988
Mailing Address - Fax:307-472-2854
Practice Address - Street 1:150 N MELROSE ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2735
Practice Address - Country:US
Practice Address - Phone:307-234-6988
Practice Address - Fax:307-472-2854
Is Sole Proprietor?:No
Enumeration Date:2016-11-30
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY23812.1577363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily