Provider Demographics
NPI:1841908134
Name:REEVES, KESHIA SHERELLE (CRMA)
Entity type:Individual
Prefix:
First Name:KESHIA
Middle Name:SHERELLE
Last Name:REEVES
Suffix:
Gender:F
Credentials:CRMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2325 ATASCOCITA RD
Mailing Address - Street 2:# C-3, C-5
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-4634
Mailing Address - Country:US
Mailing Address - Phone:936-257-3078
Mailing Address - Fax:
Practice Address - Street 1:2325 ATASCOCITA RD
Practice Address - Street 2:# C-3, C-5
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-4634
Practice Address - Country:US
Practice Address - Phone:936-257-3078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No174H00000XOther Service ProvidersHealth Educator
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX129777OtherAMT