Look up the most recent NPI and PECOS records

Misty Reeder

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

9900 Bren Rd E, Minnetonka, MN 55343-9664

PECOS Enrollment

Based on the most recent information from CMS, provider Misty Reeder does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1700130671
Provider Type
Individual
Full Name
Reeder, Misty
Title
Mrs.
Credential
FNP

Gender
Female
Sole Proprietor
No
Enumeration Date
10/31/2012
Last Updated
10/5/2020

Contact Information

Practice Location

9900 Bren Rd E, Minnetonka, MN 55343-9664

(727) 242-3295

Unlisted Fax

Mailing Location

220 23rd Ave S, St Petersburg, FL 33705-3232

(727) 242-3295

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 1700130671 Florida

Provider Identifiers

ID	Description	Issuer
ID 008031200	Description Medicaid	Issuer Unlisted Florida

Misty Reeder

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Boulet, Jimi Leah

Nicholas, Jean L

Hancock, Janet E

Gordon, Safiya A

Cope, Heather L.

Malark, Claire

Clapp, Angela M

Creel, Kimberly D

Hocking, Tracey L

Johnson, Christie E