Provider Demographics
NPI:1669342259
Name:REESE, CARLENA ELAINE
Entity type:Individual
Prefix:
First Name:CARLENA
Middle Name:ELAINE
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 1:251 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-5721
Mailing Address - Country:US
Mailing Address - Phone:513-262-9330
Mailing Address - Fax:
Practice Address - Street 1:251 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-5721
Practice Address - Country:US
Practice Address - Phone:513-262-9330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-07
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN696976172A00000X, 343900000X
OH182050376K00000X, 385HR2055X, 164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
No172A00000XOther Service ProvidersDriverGroup - Multi-Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No376K00000XNursing Service Related ProvidersNurse's Aide
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child