Provider Demographics
NPI:1801347240
Name:REAVES, SHARON DENISE (RN)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:DENISE
Last Name:REAVES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:DENISE
Other - Last Name:HAYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:437 BEAUREGARD AVE
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23805-2017
Mailing Address - Country:US
Mailing Address - Phone:804-919-3463
Mailing Address - Fax:
Practice Address - Street 1:437 BEAUREGARD AVE
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23805-2017
Practice Address - Country:US
Practice Address - Phone:804-919-3463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA001152368163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health