MS. YVONNE DERICKSON (NPI# 1003341280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003341280 |
| Entity Type | Individual |
| Full Name | MS. YVONNE DERICKSON |
| Credential | ARNP, FNP-BC |
| Practice Address |
105 Whitehall Dr Ste 115-116 St Augustine FL 32086-5269 |
| Mailing Address |
Po Box 734905 Dallas TX 75373-4905 |
| Practice Telephone | 9048007246 |
| Practice Fax Number | 9042994116 |
| Mailing Telephone | 9048007246 |
| Mailing Fax Number | 9042994116 |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2019-09-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
ARNP9228240 | FL | Allopathic & Osteopathic Physicians |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
ARNP9228240 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
105 WHITEHALL DR STE 115-116 |
| City | ST AUGUSTINE |
| State | FL |
| Zip Code | 32086-5269 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225670037 | Ramonica Flagler | Nurse Practitioner | 3574 Us-1 South, St. Augustine, FL 32086 | 2019-10-14 |
| 1518522648 | Marissa Marie Lynch | Physician Assistant | 100 Whetstone Pl Ste 102, St Augustine, FL 32086 | 2019-05-03 |
| 1346706991 | Castillo Transportation | Non-emergency Medical Transport (VAN) | 295 North Hidden Tree Dr, Saint Augustine, FL 32086 | 2019-02-19 |
| 1790255842 | Michelle Moore | In Home Supportive Care | 135 Jenkins St. Suite 105b #265, St.augustine, FL 32086 | 2018-12-03 |
| 1649740200 | Paul James Lietz IIi | Physical Therapist | One Orthopedic Place, Saint Augustine, FL 32086 | 2018-11-27 |
| 1548764707 | Oceanside Endodontics Od St. Augustine | Dentist | 2510 U.S. 1 South, Suite B, St. Augustine, FL 32086 | 2018-03-22 |
| 1023538329 | Joseph R Edwards | Physical Therapist | 968 Espinado Avenue, St Augustine, FL 32086 | 2017-06-27 |
| 1235662032 | Jennifer L Csenge | Dentist | 4327 Us Highway 1 S, St Augustine, FL 32086 | 2017-04-07 |
| 1336683663 | Lisa Brice | Social Worker | 248 Southpark Circle East, Saint Augustine, FL 32086 | 2016-12-06 |
| 1558813303 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 65 Whitehall Drive, Saint Augustine, FL 32086 | 2016-10-27 |
| Find all providers in zip 32086 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356948871 | Rachel Annette Tax | Nurse Practitioner | 325 Sunset Dr, St Augustine, FL 32080-9101 | 2020-10-07 |
| 1386260354 | Kristina Marie Hanlon | Nurse Practitioner | 119 Old Field Ln, St Augustine, FL 32092-1928 | 2020-06-24 |
| 1356977888 | Carol Christine Sickels | Nurse Practitioner | 206 Circle Dr E, St Augustine, FL 32084-0868 | 2020-03-16 |
| 1518501832 | Amanda Allen | Nurse Practitioner | 6936 Cypress Spring Ct, St Augustine, FL 32086-4818 | 2019-10-30 |
| 1023576360 | Folasade Sanusi Olushola | Nurse Practitioner | 2604 Torino Way, St Augustine, FL 32092-4784 | 2019-03-06 |
| 1326502600 | Ashley Fisher Roussell | Nurse Practitioner | 2720 Us Highway 1 S Ste B, St Augustine, FL 32086-6371 | 2019-01-30 |
| 1336658103 | Nena Sheryl Morden | Nurse Practitioner | 100 Whetstone Pl Ste 205, St Augustine, FL 32086-5775 | 2017-09-25 |
| 1245770742 | Linda Gillis | Nurse Practitioner | 143 Portada Dr, St Augustine, FL 32095-1634 | 2017-03-02 |
| 1457779316 | Candace Smith | Nurse Practitioner | 2513 Otter Totem Ct, St Augustine, FL 32092-2445 | 2014-03-28 |
| 1720328321 | Sharon Lynn Steinmetz | Nurse Practitioner | 6170 A1a S Unit 304, St Augustine, FL 32080-7537 | 2013-02-20 |
| Find all providers in ST AUGUSTINE | ||||
| City | ST AUGUSTINE |
| Zip Code | 32086 |
Please comment or provide details below to improve the information on MS. YVONNE DERICKSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.