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Contact Information

MARY L BLAKE REEVES
4626 LEE AVE
SAINT LOUIS, MO63115-2431
 Phone: 314-385-7726
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for MARY L BLAKE REEVES · (Female)

NPI Number 1710937073
Status Active
Credentials
Entity Individual
Enumeration date 05/10/2006
Last updated 09/19/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 068911
  • MO Medicaid 427399902
  • MO Medicaid 815032931
  • MO Other 11646789 CAQH
  • MO Other 1710937073 NATIONAL PROVIDER IDENTIFIER
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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