Provider Demographics
NPI:1326289125
Name:SAYRE, DUSTY G (RN)
Entity Type:Individual
Prefix:
First Name:DUSTY
Middle Name:G
Last Name:SAYRE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 LEE AVE
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-6508
Mailing Address - Country:US
Mailing Address - Phone:850-488-7935
Mailing Address - Fax:850-488-0918
Practice Address - Street 1:1126 LEE AVE
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-6508
Practice Address - Country:US
Practice Address - Phone:850-488-7935
Practice Address - Fax:850-488-0918
Is Sole Proprietor?:No
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9273633163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management