Provider Demographics
NPI:1740669332
Name:REEVES, TROY S (FNP)
Entity type:Individual
Prefix:MR
First Name:TROY
Middle Name:S
Last Name:REEVES
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 HAYES AVENUE
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-3323
Mailing Address - Country:US
Mailing Address - Phone:419-557-7455
Mailing Address - Fax:
Practice Address - Street 1:1111 HAYES AVENUE
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870
Practice Address - Country:US
Practice Address - Phone:419-557-7400
Practice Address - Fax:419-557-7782
Is Sole Proprietor?:No
Enumeration Date:2015-05-28
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11001406363LF0000X
MI4704341774363L00000X
NY343842363L00000X
OHCOA.17371-NP363LF0000X
OH17371-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHAPRN.CNP.17371OtherOH MEDICAL LICENSE
OH0134623Medicaid