IndividualActive
Tracey Reeve, PA-C
NPI 1174789994 · Surgical Physician Assistant · Meridian, ID
Provider details
- NPI number
- 1174789994
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- PA-1159 (ID)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
520 S Eagle Rd Ste 1241
Meridian, ID 83642-6355
Phone: (208) 381-6930
Fax: (208) 381-6931
Approximate (ZIP-level) locationGet directions
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Additional practice locations (1)
- 999 N Curtis RdSuite 415Boise, ID 83706-1334Phone: (208) 367-7676Fax: (208) 367-5595
Registry dates
- Enumerated
- 2008-07-31
- Last updated
- 2023-08-30
- Certified
- 2023-08-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.