Provider Demographics
NPI:1295012540
Name:REEVES, CHARLOTTE JANE
Entity Type:Individual
Prefix:MRS
First Name:CHARLOTTE
Middle Name:JANE
Last Name:REEVES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 BROOKE LN
Mailing Address - Street 2:
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701-1779
Mailing Address - Country:US
Mailing Address - Phone:580-924-5331
Mailing Address - Fax:580-920-2004
Practice Address - Street 1:165 BROOKE LN
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701-1779
Practice Address - Country:US
Practice Address - Phone:580-924-5331
Practice Address - Fax:580-920-2004
Is Sole Proprietor?:No
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator