Provider Demographics
NPI:1164546131
Name:REEVES, ROXY (CNM)
Entity Type:Individual
Prefix:
First Name:ROXY
Middle Name:
Last Name:REEVES
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:ROXANNE
Other - Middle Name:
Other - Last Name:REEVES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNM
Mailing Address - Street 1:311 KALANIANAOLE AVE
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-4740
Mailing Address - Country:US
Mailing Address - Phone:808-969-1427
Mailing Address - Fax:808-961-5167
Practice Address - Street 1:311 KALANIANAOLE AVE
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4740
Practice Address - Country:US
Practice Address - Phone:808-969-1427
Practice Address - Fax:808-961-5167
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN 56928163W00000X
CA353102163W00000X
HIAPRN 910363L00000X
CA4886363L00000X
CACNM 749367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Not Answered367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife