Reeves, Jack Edward

Reeves, Jack Edward is an sole proprietor health care provider with primary practice located at 3309 Wildwood Ln , Wausau WI 54401-4094. He recently has only one registered license in Nursing Service Providers / Registered Nurse, which is considered as his primary health care specialty. Reeves, Jack Edward can be contacted via phone (630) 886-0222.

Contact Information

Primary practice address
3309 Wildwood Ln Wausau WI 54401-4094
Phone: (630) 886-0222
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X Wisconsin

Profile Details

NPI number 1043499379
LBN Legal business name Reeves, Jack Edward
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 2nd, 2007
Last updated Nov 2nd, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043499379 NPPES
Wisconsin MEDICAID 35040400

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