Individual
MS. DIANE M REEVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1000 HEALTH SERVICE DR., KYLE I.H.S. OUT PATIENT CLINIC, KYLE, SD 57752
(605) 455-2451
(605) 455-1529
Mailing address
1000 HEALTH SERVICE DR., KYLE I.H.S. OUT PATIENT CLINIC, KYLE, SD 57752
(605) 455-2451
(605) 455-1529
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
41808
TX
183500000X
Pharmacist
5302026024
MI
363A00000X
Physician Assistant
5601002364
MI
363A00000X
Physician Assistant
Primary
PA03219
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
138950100
FIRST CARE
TX
01
—
8N7081
BCBS
TX
Enumeration date
08/23/2006
Last updated
05/23/2012
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