Provider Demographics
NPI:1679161251
Name:RIX, RESHINA RENEE (RN)
Entity Type:Individual
Prefix:MS
First Name:RESHINA
Middle Name:RENEE
Last Name:RIX
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 1:600 JIMMY ANN DR APT 1014
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-1352
Mailing Address - Country:US
Mailing Address - Phone:386-275-5559
Mailing Address - Fax:
Practice Address - Street 1:1725 FIFTH ST
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-5107
Practice Address - Country:US
Practice Address - Phone:386-274-4172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9542211163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLR200736871860OtherDRIVER LISCENSE