Provider Demographics
NPI:1891438222
Name:NIMLEY-REEVES, JANICE W
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:W
Last Name:NIMLEY-REEVES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:639 33RD AVE W APT 219
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-7795
Mailing Address - Country:US
Mailing Address - Phone:701-200-6880
Mailing Address - Fax:
Practice Address - Street 1:639 33RD AVE W APT 219
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-7795
Practice Address - Country:US
Practice Address - Phone:701-200-6880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-14
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health