Provider Demographics
NPI:1831988815
Name:REEVES, SHANIA MARIE
Entity type:Individual
Prefix:
First Name:SHANIA
Middle Name:MARIE
Last Name:REEVES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 OAK ST
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:NE
Mailing Address - Zip Code:68784-5225
Mailing Address - Country:US
Mailing Address - Phone:712-577-6575
Mailing Address - Fax:
Practice Address - Street 1:3206 RAASCH DR STE 300
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-3175
Practice Address - Country:US
Practice Address - Phone:402-379-3888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-05
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE113040374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty