Provider Demographics
NPI:1598498172
Name:REEVES, SANDY DELORES (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SANDY
Middle Name:DELORES
Last Name:REEVES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:439 FM 1730
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:TX
Mailing Address - Zip Code:79381-2306
Mailing Address - Country:US
Mailing Address - Phone:806-928-9089
Mailing Address - Fax:
Practice Address - Street 1:416 FRANKFORD AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79416-4162
Practice Address - Country:US
Practice Address - Phone:806-743-2424
Practice Address - Fax:806-743-9363
Is Sole Proprietor?:No
Enumeration Date:2022-07-01
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1086281363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily