Provider Demographics
NPI:1306397815
Name:REEVES, JOSEPH (RN , WCCM)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:REEVES
Suffix:
Gender:M
Credentials:RN , WCCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 SWAGGERS POINT RD
Mailing Address - Street 2:
Mailing Address - City:SOLOMONS
Mailing Address - State:MD
Mailing Address - Zip Code:20688-3010
Mailing Address - Country:US
Mailing Address - Phone:301-991-4513
Mailing Address - Fax:877-631-0996
Practice Address - Street 1:510 SWAGGERS POINT RD
Practice Address - Street 2:
Practice Address - City:SOLOMONS
Practice Address - State:MD
Practice Address - Zip Code:20688-3010
Practice Address - Country:US
Practice Address - Phone:301-991-4513
Practice Address - Fax:877-631-0996
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR126173163WC0400X
DCRN1039934163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management