Provider Demographics
NPI:1528664133
Name:REESE, MARGARET
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:REESE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10133 FAIRMOUNT RD
Mailing Address - Street 2:
Mailing Address - City:NEWBURY
Mailing Address - State:OH
Mailing Address - Zip Code:44065-9531
Mailing Address - Country:US
Mailing Address - Phone:440-667-8132
Mailing Address - Fax:
Practice Address - Street 1:10133 FAIRMOUNT RD
Practice Address - Street 2:
Practice Address - City:NEWBURY
Practice Address - State:OH
Practice Address - Zip Code:44065-9531
Practice Address - Country:US
Practice Address - Phone:440-667-8132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2800286376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2062351Medicaid