Provider Demographics
NPI:1013502210
Name:REEVES, KINSEY KAY
Entity type:Individual
Prefix:
First Name:KINSEY
Middle Name:KAY
Last Name:REEVES
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:KINSEY
Other - Middle Name:K
Other - Last Name:REEVES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN, APRN, PMHNP-BC
Mailing Address - Street 1:830 W SOUTH BOUNDARY ST STE A
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-5238
Mailing Address - Country:US
Mailing Address - Phone:419-931-3020
Mailing Address - Fax:
Practice Address - Street 1:830 W SOUTH BOUNDARY ST
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-5238
Practice Address - Country:US
Practice Address - Phone:419-931-3020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0028497363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health