Provider Demographics
NPI:1972269017
Name:REEVES, CHELSIE
Entity Type:Individual
Prefix:
First Name:CHELSIE
Middle Name:
Last Name:REEVES
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 1:16809 MALADY RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT ORAB
Mailing Address - State:OH
Mailing Address - Zip Code:45154-8734
Mailing Address - Country:US
Mailing Address - Phone:937-731-8343
Mailing Address - Fax:
Practice Address - Street 1:20631 BLACK OAK RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45118-9790
Practice Address - Country:US
Practice Address - Phone:937-731-8343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-12
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide