Provider Demographics
NPI:1497640387
Name:REEVES, LISA MARIE (LPN)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:REEVES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3238 WINTON RD S # 34
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-5968
Mailing Address - Country:US
Mailing Address - Phone:585-713-5476
Mailing Address - Fax:
Practice Address - Street 1:3238 WINTON RD S # 34
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-5968
Practice Address - Country:US
Practice Address - Phone:585-713-5476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY249545164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse