Provider Demographics
NPI:1790288694
Name:MOREE, SUZANNE (ARNP-FNP-BC)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:MOREE
Suffix:
Gender:F
Credentials:ARNP-FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BALD EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32459-8342
Mailing Address - Country:US
Mailing Address - Phone:850-517-0877
Mailing Address - Fax:
Practice Address - Street 1:10 BALD EAGLE DR
Practice Address - Street 2:
Practice Address - City:SANTA ROSA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32459-8342
Practice Address - Country:US
Practice Address - Phone:850-517-0877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-16
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9317115363LF0000X
FLAPRN9317115363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty