Provider Demographics
NPI:1851593594
Name:MELANIE A REAVES PLLC
Entity Type:Organization
Organization Name:MELANIE A REAVES PLLC
Other - Org Name:THE FAMILY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:REAVES
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:731-925-3354
Mailing Address - Street 1:PO BOX 55
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:TN
Mailing Address - Zip Code:38372-0055
Mailing Address - Country:US
Mailing Address - Phone:731-925-3354
Mailing Address - Fax:731-925-2031
Practice Address - Street 1:1440 PICKWICK ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:TN
Practice Address - Zip Code:38372
Practice Address - Country:US
Practice Address - Phone:731-925-3354
Practice Address - Fax:731-438-3581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QR1300X
TN11354363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty