Derrick Devonne Seals, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11017969 Issued in FL

Practice address

1872 Wareham Way
Cantonment, FL 32533-5631

Phone

(850) 206-5159

NPI assigned

Feb 7, 2022

Last updated

Feb 7, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1245984525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1872 WAREHAM WAY",
            "city": "CANTONMENT",
            "state": "FL",
            "postal_code": "325335631",
            "telephone_number": "850-206-5159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1872 WAREHAM WAY",
            "city": "CANTONMENT",
            "state": "FL",
            "postal_code": "325335631",
            "telephone_number": "850-206-5159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEALS",
        "first_name": "DERRICK",
        "middle_name": "DEVONNE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-07",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11017969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Cantonment, FL
• Providers in Cantonment, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.