Individual
MICHAELA ANNIS DERIVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3355 CLAIRE LN APT 1505, JACKSONVILLE, FL 32223-6660
(904) 916-1506
Mailing address
3355 CLAIRE LN APT 1505, JACKSONVILLE, FL 32223-6660
(904) 916-1506
(904) 916-1506
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5259137
FL
Other
Enumeration date
01/29/2026
Last updated
01/29/2026
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