Provider Demographics
NPI:1316076904
Name:REESER, VIRGINIA ANN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:ANN
Last Name:REESER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 N CAVALIER DR
Mailing Address - Street 2:
Mailing Address - City:ALAMO
Mailing Address - State:TN
Mailing Address - Zip Code:38001-6468
Mailing Address - Country:US
Mailing Address - Phone:731-696-4500
Mailing Address - Fax:
Practice Address - Street 1:18 N CAVALIER DR
Practice Address - Street 2:
Practice Address - City:ALAMO
Practice Address - State:TN
Practice Address - Zip Code:38001-6468
Practice Address - Country:US
Practice Address - Phone:724-773-1941
Practice Address - Fax:724-773-8370
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA001464L363AM0700X
TNPA000005477363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS47449Medicare UPIN