Provider Demographics
NPI:1336895556
Name:REEVES, LINDSAY MARIE (FNP-C)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MARIE
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 1:1957 THOMPSON RD STE G
Mailing Address - Street 2:
Mailing Address - City:COOS BAY
Mailing Address - State:OR
Mailing Address - Zip Code:97420-2040
Mailing Address - Country:US
Mailing Address - Phone:541-404-6848
Mailing Address - Fax:541-982-7283
Practice Address - Street 1:1957 THOMPSON RD STE G
Practice Address - Street 2:
Practice Address - City:COOS BAY
Practice Address - State:OR
Practice Address - Zip Code:97420-2040
Practice Address - Country:US
Practice Address - Phone:541-404-6848
Practice Address - Fax:541-982-7283
Is Sole Proprietor?:No
Enumeration Date:2022-02-25
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202201525NP2083B0002X, 363LF0000X
OR202201525NP-PP2083B0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity Medicine