Individual
SARA WATERBURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, PMHNP-BC, RN
Contact information
Practice address
1680 SW BAYSHORE BLVD STE 107, PORT ST LUCIE, FL 34984-3518
(772) 249-2597
Mailing address
310 BEACH AVE, PORT ST LUCIE, FL 34952-1371
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9392585
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11022114
FL
Other
Enumeration date
10/25/2022
Last updated
08/01/2024
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