Individual
SHERRY DIANNE DEKEYSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
203 FORT WADE RD UNIT 260, PONTE VEDRA, FL 32081-5159
(904) 902-4408
Mailing address
3300 N TRIUMPH BLVD STE 500, LEHI, UT 84043-6475
(801) 821-2333
(801) 901-1194
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
10690
SD
2084P0800X
Psychiatry Physician
36746
IA
2084P0800X
Psychiatry Physician
50674
AZ
2084P0800X
Psychiatry Physician
Primary
ME162610
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0495341
—
IA
01
—
20589
WELLMARK BLUE CROSS BLUE
IA
Enumeration date
05/25/2006
Last updated
04/23/2024
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