Individual
MRS. MISTY REEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
9900 BREN RD E, MINNETONKA, MN 55343-9664
(727) 242-3295
Mailing address
220 23RD AVE S, ST PETERSBURG, FL 33705-3232
(727) 242-3295
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1700130671
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008031200
—
FL
Enumeration date
10/31/2012
Last updated
10/05/2020
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