Individual
TINA R REEVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
530 S MAIDEN LN, JOPLIN, MO 64801-3084
(417) 782-6200
(417) 782-6210
Mailing address
4301 DONIPHAN DR, NEOSHO, MO 64850-9120
(417) 451-9450
(417) 451-8903
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
148710
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
194619
ANTHEM
MO
05
—
200036220A
—
OK
05
—
200267590A
—
KS
05
—
429002702
—
MO
01
—
P00146240
RR MEDICARE
—
Enumeration date
07/05/2006
Last updated
03/06/2012
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