Derek Jason Sisk
Nurse Practitioner
3554 65th Avenue Cir E
Sarasota
, Florida 34243-4116
Derek Jason Sisk
Nurse Practitioner
3554 65th Avenue Cir E
Sarasota
, Florida 34243-4116
(941) 250-4279
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About
Features
Specialties
- Nurse Practitioner
Languages spoken
- English
Location
First Address
- Derek Jason Sisk
- 3554 65th Avenue Cir E
- Sarasota, FL
- Zip : 34243-4116
- Phone : (941) 250-4279
Second Address
- Derek Jason Sisk
- 3554 65th Avenue Cir E
- Sarasota, FL
- Zip : 34243-4116
- Phone : (941) 250-4279
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 11008173 | FL |
National Provider Identifier
| NPI | 1003428707 |
|---|---|
| Provider Name | Derek Jason Sisk |
| First Address | Sarasota, FL 34243-4116 |
| Second Address | Sarasota, FL 34243-4116 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 24/08/2020 |
| Last Update Date | 24/08/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.