Provider Demographics
NPI:1295880128
Name:MASSEY, JACQUELINE LEE (RRT)
Entity type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:LEE
Last Name:MASSEY
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8153 CEDAR CREEK DR
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-2344
Mailing Address - Country:US
Mailing Address - Phone:727-845-7799
Mailing Address - Fax:
Practice Address - Street 1:8153 CEDAR CREEK DR
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-2344
Practice Address - Country:US
Practice Address - Phone:727-845-7799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT38112279H0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredHome Health