Individual
MRS. JENNIFER DERONVILLE STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
777 GLADES RD, BOCA RATON, FL 33431-6424
(561) 297-3000
Mailing address
2920 NW 25TH ST, FORT LAUDERDALE, FL 33311-2836
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9460025
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
11027659
FL
Other
Enumeration date
11/02/2023
Last updated
11/02/2023
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