Provider Demographics
NPI:1356696991
Name:REESE, LAUREN JANA (AP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:JANA
Last Name:REESE
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 CORPORATE DR STE 270
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-6600
Mailing Address - Country:US
Mailing Address - Phone:561-336-3144
Mailing Address - Fax:561-509-8867
Practice Address - Street 1:1501 CORPORATE DR STE 270
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-6600
Practice Address - Country:US
Practice Address - Phone:561-336-3144
Practice Address - Fax:561-509-8867
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-19
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2604171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty