Provider Demographics
NPI:1932487121
Name:REEVER, LAUREL L (FNP)
Entity Type:Individual
Prefix:
First Name:LAUREL
Middle Name:L
Last Name:REEVER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 MILL ST
Mailing Address - Street 2:
Mailing Address - City:WALDOBORO
Mailing Address - State:ME
Mailing Address - Zip Code:04572-6013
Mailing Address - Country:US
Mailing Address - Phone:207-832-5291
Mailing Address - Fax:207-832-7340
Practice Address - Street 1:27 MILL ST
Practice Address - Street 2:
Practice Address - City:WALDOBORO
Practice Address - State:ME
Practice Address - Zip Code:04572-6013
Practice Address - Country:US
Practice Address - Phone:207-832-5291
Practice Address - Fax:207-832-7340
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP111045363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily