Provider Demographics
NPI:1407494479
Name:REEVES, WILLIAM JASON (MSN, PMHNP)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JASON
Last Name:REEVES
Suffix:
Gender:M
Credentials:MSN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 HURLOCK LN
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:OH
Mailing Address - Zip Code:43119-8759
Mailing Address - Country:US
Mailing Address - Phone:614-285-2147
Mailing Address - Fax:
Practice Address - Street 1:8483 TORWOODLEE CT
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-9739
Practice Address - Country:US
Practice Address - Phone:855-677-1677
Practice Address - Fax:614-643-5503
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-20
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.423089163W00000X
OH0032009363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse