Healthcare Provider Details

I. General information

NPI: 1265404149
Provider Name (Legal Business Name): SUE ANN DAY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 11/27/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4790 BARKLEY CIR BUILDING A
FORT MYERS FL
33907-7543
US

IV. Provider business mailing address

14541 CYPRESS TRACE CT
FORT MYERS FL
33919-6860
US

V. Phone/Fax

Practice location:
  • Phone: 239-275-8882
  • Fax:
Mailing address:
  • Phone: 239-590-0875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP1266572
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: