Provider Demographics
NPI:1851905137
Name:REEVES, SHELBY (FNP-C)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:
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 1:1181 SHERMAN DR
Mailing Address - Street 2:
Mailing Address - City:STURGIS
Mailing Address - State:MS
Mailing Address - Zip Code:39769-9155
Mailing Address - Country:US
Mailing Address - Phone:601-941-6251
Mailing Address - Fax:
Practice Address - Street 1:900 STARK RD
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-3613
Practice Address - Country:US
Practice Address - Phone:662-268-6278
Practice Address - Fax:877-355-6934
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS904128363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily