# EQUISENTIAL PRIMARY HEALTHCARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073155107
- **Authorized official:** CLAUDETTE JOHNSTON-CREARY APRN (OWNER)
- **Authorized official phone:** (772) 342-3794

## Contact information

- **Practice address:** 2637 SW IMPORT DR, PORT ST LUCIE, FL 34987-2056
- **Practice address phone:** (772) 342-3794
- **Practice address fax:** (772) 365-0456
- **Mailing address:** 2637 SW IMPORT DR, PORT ST LUCIE, FL 34987-2056
- **Mailing address phone:** (772) 342-3794
- **Mailing address fax:** (772) 365-0456

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 10/10/2019
- **Last updated:** 05/08/2020