Provider Demographics
NPI:1356417083
Name:REESE, CARI LEE (APRN)
Entity type:Individual
Prefix:
First Name:CARI
Middle Name:LEE
Last Name:REESE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CARI
Other - Middle Name:LEE
Other - Last Name:WIDMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:640 W MOANA LN
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-4903
Mailing Address - Country:US
Mailing Address - Phone:775-324-0699
Mailing Address - Fax:775-323-6814
Practice Address - Street 1:1075 N HILLS BLVD
Practice Address - Street 2:#180
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89506-5732
Practice Address - Country:US
Practice Address - Phone:775-982-5000
Practice Address - Fax:775-982-6558
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00141403163W00000X
WAAP30007511363LA2100X
NVAPRN001249363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
12183148OtherCAQH
NV1356417083Medicaid
NVEY108WMedicare PIN
NVEY108VMedicare PIN
NVEY108XMedicare PIN
NVV106597Medicare PIN