Individual
GUSTI LABATTE-DENEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1632 SW IVY ST, PORT ST LUCIE, FL 34987-2248
(917) 207-4785
(718) 740-9876
Mailing address
1632 SW IVY ST, PORT ST LUCIE, FL 34987-2248
(917) 207-4785
(718) 740-9876
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
304259
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
9263802
FL
363LA2200X
Adult Health Nurse Practitioner
ARNP9263802
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016402900
—
FL
01
—
DI234Y
MEDICARE PTAN
FL
Enumeration date
06/03/2008
Last updated
10/02/2017
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