Individual
MRS. KEMI IYABO REEVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN, GNP
Contact information
Practice address
4911 VAN NUYS BLVD, SUITE 100, SHERMAN OAKS, CA 91403-1716
(504) 259-8657
Mailing address
20224 SHERMAN WAY, UNIT #54, WINNETKA, CA 91306-3237
(504) 259-8657
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
19436
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1841520939
—
CA
Enumeration date
01/12/2010
Last updated
04/09/2012
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