Provider Demographics
NPI:1861672974
Name:REECEGATES, LANA JANE
Entity Type:Individual
Prefix:MRS
First Name:LANA
Middle Name:JANE
Last Name:REECEGATES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400A RICHARD PL
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63115-2539
Mailing Address - Country:US
Mailing Address - Phone:314-389-1221
Mailing Address - Fax:314-389-1221
Practice Address - Street 1:4400A RICHARD PL
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63115-2539
Practice Address - Country:US
Practice Address - Phone:314-389-1221
Practice Address - Fax:314-389-1221
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health