Provider Demographics
NPI:1578447116
Name:REESE, ABIGAIL (PA)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:REESE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 FILSON BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-8993
Mailing Address - Country:US
Mailing Address - Phone:803-530-6980
Mailing Address - Fax:
Practice Address - Street 1:106 FILSON BLUFF DR
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-8993
Practice Address - Country:US
Practice Address - Phone:803-530-6980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant