Provider Demographics
NPI:1417224114
Name:REEVES, JOHN W III (LPN)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:W
Last Name:REEVES
Suffix:III
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1195 SELMI DR
Mailing Address - Street 2:UNIT D-207
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89512-7719
Mailing Address - Country:US
Mailing Address - Phone:775-771-7339
Mailing Address - Fax:
Practice Address - Street 1:1195 SELMI DR
Practice Address - Street 2:UNIT D-207
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89512-7719
Practice Address - Country:US
Practice Address - Phone:775-771-7339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVLPN12616164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse