Provider Demographics
NPI:1457530909
Name:WHITING- REESE, SUZETTE (RN)
Entity Type:Individual
Prefix:
First Name:SUZETTE
Middle Name:
Last Name:WHITING- REESE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SUZETTE
Other - Middle Name:
Other - Last Name:REESE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:1140 PRATT BLVD
Mailing Address - Street 2:PO BOX 70
Mailing Address - City:LABELLE
Mailing Address - State:FL
Mailing Address - Zip Code:33935-4405
Mailing Address - Country:US
Mailing Address - Phone:863-674-4041
Mailing Address - Fax:863-674-4604
Practice Address - Street 1:1140 PRATT BLVD
Practice Address - Street 2:
Practice Address - City:LABELLE
Practice Address - State:FL
Practice Address - Zip Code:33935-4405
Practice Address - Country:US
Practice Address - Phone:863-674-4041
Practice Address - Fax:863-674-4604
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1772052163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse