Provider Demographics
NPI:1265011605
Name:MAYE, REAGAN FRINCKS (APRN)
Entity Type:Individual
Prefix:MR
First Name:REAGAN FRINCKS
Middle Name:
Last Name:MAYE
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 158
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:FL
Mailing Address - Zip Code:32663-0158
Mailing Address - Country:US
Mailing Address - Phone:352-840-6421
Mailing Address - Fax:
Practice Address - Street 1:3269 NW 105TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34475-1328
Practice Address - Country:US
Practice Address - Phone:352-278-5328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-05
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11009541363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner