Individual
GARRY DESULME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
1700 S 23RD ST, FORT PIERCE, FL 34950-4803
(772) 203-2661
Mailing address
373 SW DONNA TER, PORT ST LUCIE, FL 34984-4358
(772) 203-2661
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11004108
FL
363LG0600X
Gerontology Nurse Practitioner
APRN11004108
FL
Other
Enumeration date
09/14/2019
Last updated
02/14/2024
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