Provider Demographics
NPI:1649507757
Name:REEVES, KARI TRAHAN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:KARI
Middle Name:TRAHAN
Last Name:REEVES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:KARI
Other - Middle Name:RENEE
Other - Last Name:TRAHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5408 FLANDERS DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-9137
Mailing Address - Country:US
Mailing Address - Phone:225-769-5554
Mailing Address - Fax:225-769-5502
Practice Address - Street 1:5408 FLANDERS DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-9137
Practice Address - Country:US
Practice Address - Phone:225-769-5554
Practice Address - Fax:225-769-5502
Is Sole Proprietor?:No
Enumeration Date:2009-11-10
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPA.200308363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical