Provider Demographics
NPI:1639108491
Name:FEE, SANRA SUE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:SANRA
Middle Name:SUE
Last Name:FEE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12995 S CLEVELAND AVE STE 184
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-7703
Mailing Address - Country:US
Mailing Address - Phone:239-939-2201
Mailing Address - Fax:239-939-7572
Practice Address - Street 1:12995 S CLEVELAND AVE STE 184
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-7703
Practice Address - Country:US
Practice Address - Phone:239-939-2201
Practice Address - Fax:239-939-7572
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1583852363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y5174Medicare ID - Type Unspecified
FLS49898Medicare UPIN