Provider Demographics
NPI:1285195834
Name:REAVIS, HANNAH SWAN (MD)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:SWAN
Last Name:REAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:SWAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9411 N OAK TRFY STE LL1
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-2262
Mailing Address - Country:US
Mailing Address - Phone:816-691-1655
Mailing Address - Fax:
Practice Address - Street 1:2790 CLAY EDWARDS DR STE 530
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3266
Practice Address - Country:US
Practice Address - Phone:816-452-3300
Practice Address - Fax:816-453-0677
Is Sole Proprietor?:No
Enumeration Date:2019-03-27
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO390200000X
MO2023013956207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program