Individual
BARBARA NYCE REESOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
115 S GLORIA ST, CLEWISTON, FL 33440-3505
(863) 983-2282
(863) 983-2864
Mailing address
115 S GLORIA ST, CLEWISTON, FL 33440-3505
(863) 983-2282
(863) 983-2864
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9108107
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA9108107
FL LICENSE NUMBER
FL
Enumeration date
08/29/2014
Last updated
08/29/2014
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