Provider Demographics
NPI:1093348674
Name:MESSIER, RENE JOSEPH III (APRN FP-C)
Entity Type:Individual
Prefix:MR
First Name:RENE
Middle Name:JOSEPH
Last Name:MESSIER
Suffix:III
Gender:M
Credentials:APRN FP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5430 1ST AVE E APT 202
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-6166
Mailing Address - Country:US
Mailing Address - Phone:205-876-4223
Mailing Address - Fax:
Practice Address - Street 1:5430 1ST AVE E APT 202
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-6166
Practice Address - Country:US
Practice Address - Phone:205-876-4223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-21
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9340113163W00000X
FLNONE163WR0006X
FLF01200853363LF0000X
FL11005972363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily