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Individual
AMY STANTON REAVES
Active
Individual
AMY STANTON REAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1285
SC
363AM0700X
Medical Physician Assistant
1285
SC
363AS0400X
Surgical Physician Assistant
Primary
1285
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0631PA
—
SC
01
—
13347593
MULTIPLAN PROVIDER NO.
SC
01
—
1902246077
ARCIS HEALTHCARE GROUP NPI NO.
SC
01
—
2864256
UNITED HEALTHCARE MPIN NO.
SC
01
—
45168
ARCIS HEALTHCARE MULTIPLAN GROUP NO.
SC
01
—
4920537
AETNA PIN NO.
SC
01
—
983747
WELLCARE PROVIDER ID NO.
SC
01
—
D043
ARCIS HEALTHCARE GROUP MEDICARE PTAN
SC
01
—
DU4331
ARCIS HEALTHCARE GROUP RAILROAD MEDICARE PTAN
SC
01
—
GP6337
ARCIS HEALTHCARE GROUP MEDICAID LEGACY NO.
SC
01
—
P01337502
RAILROAD MEDICARE PTAN
SC
Enumeration date
01/07/2008
Last updated
07/05/2016
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