Provider Demographics
NPI:1285496125
Name:REEVES, KAYLA COLLEEN (FNP-C)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:COLLEEN
Last Name:REEVES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:COLLEEN
Other - Last Name:BINNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:324 HOLLYHOCK DR
Mailing Address - Street 2:
Mailing Address - City:CAMDENTON
Mailing Address - State:MO
Mailing Address - Zip Code:65020-9810
Mailing Address - Country:US
Mailing Address - Phone:573-480-2740
Mailing Address - Fax:
Practice Address - Street 1:1029 NICHOLS RD STE 301
Practice Address - Street 2:
Practice Address - City:OSAGE BEACH
Practice Address - State:MO
Practice Address - Zip Code:65065-3008
Practice Address - Country:US
Practice Address - Phone:573-302-2864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-26
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024002804207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine