Basic Information
| Provider Information | |||||||||
| NPI: | 1164546131 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REEVES | ||||||||
| FirstName: | ROXY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
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| Credential: | CNM | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | REEVES | ||||||||
| OtherFirstName: | ROXANNE | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | CNM | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 311 KALANIANAOLE AVE | ||||||||
| Address2: | |||||||||
| City: | HILO | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967204740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8089691427 | ||||||||
| FaxNumber: | 8089615167 | ||||||||
| Practice Location | |||||||||
| Address1: | 311 KALANIANAOLE AVE | ||||||||
| Address2: | |||||||||
| City: | HILO | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967204740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8089691427 | ||||||||
| FaxNumber: | 8089615167 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN 56928 | HI | X | Nursing Service Providers | Registered Nurse | 163W00000X | 353102 | CA | X | Nursing Service Providers | Registered Nurse | 363L00000X | APRN 910 | HI | X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363L00000X | 4886 | CA | X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 367A00000X | CNM 749 | CA | X | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.