Provider Demographics
NPI:1295011971
Name:REESE, DAPRISHA D (LPN)
Entity Type:Individual
Prefix:
First Name:DAPRISHA
Middle Name:D
Last Name:REESE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7149 WARWICK DR
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-3187
Mailing Address - Country:US
Mailing Address - Phone:734-560-6950
Mailing Address - Fax:
Practice Address - Street 1:7149 WARWICK DR
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-3187
Practice Address - Country:US
Practice Address - Phone:734-560-6950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-26
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-145-701-M-IV164W00000X
MI4703110788164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2891063Medicaid