Provider Demographics
NPI:1265404149
Name:DAY, SUE ANN (ARNP)
Entity type:Individual
Prefix:MRS
First Name:SUE
Middle Name:ANN
Last Name:DAY
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 1:14541 CYPRESS TRACE CT
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-6860
Mailing Address - Country:US
Mailing Address - Phone:239-590-0875
Mailing Address - Fax:
Practice Address - Street 1:4790 BARKLEY CIR
Practice Address - Street 2:BUILDING A
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-7543
Practice Address - Country:US
Practice Address - Phone:239-275-8882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-03
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1266572363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00471140OtherRAILROAD MEDICARE
FL002403600Medicaid
FLU1617VOtherMEDICARE ID
FLP00471140OtherRAILROAD MEDICARE