Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | APRN11008970 | FL |
NPI | 1003422577 |
---|---|
Provider Name | Octavia Deuschle |
First Address | Naples, FL 34102-8128 |
Second Address | Naples, FL 34102-6575 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2020 |
Last Update Date | 24/05/2021 |