Provider Demographics
NPI:1689982308
Name:SUTHERLAND, JOAN V (RN)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:V
Last Name:SUTHERLAND
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 1:14495 SE 80TH AVE
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:FL
Mailing Address - Zip Code:34491-3319
Mailing Address - Country:US
Mailing Address - Phone:352-347-7232
Mailing Address - Fax:353-620-2136
Practice Address - Street 1:2319 SE 58TH AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34480-5840
Practice Address - Country:US
Practice Address - Phone:352-620-0700
Practice Address - Fax:352-620-2136
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2245092163WE0003X, 163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency
No163WP0200XNursing Service ProvidersRegistered NursePediatrics