Basic Information
Provider Information
NPI: 1528516622
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: REEVES
FirstName: CORINNE
MiddleName: ALMQUIST
NamePrefix: MRS.
NameSuffix:  
Credential: CNM, WHNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2111 EXCHANGE ST
Address2:  
City: ASTORIA
State: OR
PostalCode: 971033329
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 2265 EXCHANGE ST
Address2:  
City: ASTORIA
State: OR
PostalCode: 971033331
CountryCode: US
TelephoneNumber: 5033387595
FaxNumber: 5033254906
Other Information
ProviderEnumerationDate: 09/17/2016
LastUpdateDate: 06/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/21/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367A00000X201607296NP-PP Y Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 

No ID Information.


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