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Daegavinchris,llc
Gerontology Nurse Practitioner in Port St Lucie, Florida
NPI 1891337655

Daegavinchris,llc is a Gerontology Nurse Practitioner based in Port St Lucie, FL and is specialized in Gerontology. Daegavinchris,llc practices in Port St Lucie, FL. The NPI Number for Daegavinchris,llc is 1891337655 and holds a License No. (Florida).

The current practice location address for Daegavinchris,llc is 4574 Sw Tabor St, Port St Lucie, FL and can be reached out via phone at 772-626-1002 and via fax at 772-871-0055.

Location: 4574 Sw Tabor St, Port St Lucie, FL, 34953-6740
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1891337655
Provider Name
Daegavinchris,llc
Credential
Provider Entity Type
Organization
Address
4574 Sw Tabor St, Port St Lucie, FL, 34953-6740
Phone Number
772-626-1002
Fax Number
772-871-0055
Provider Enumeration Date
10/14/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4574 Sw Tabor St
City
Port St Lucie
State
Florida
Zip
34953-6740
Phone Number
772-626-1002
Fax Number
772-871-0055
person
Provider Business Mailing Address Details
Address
4574 Sw Tabor St
City
Port St Lucie
State
Florida
Zip
34953-6740
Phone Number
772-626-1002
Fax Number
772-871-0055
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Gerontology
Taxonomy
363LG0600X
License No.
()
Definition
Definition to come...
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