Individual provider Active NPI

Davene Alexandra Derosier, APRN

  • Family Nurse Practitioner
  • Port St Lucie, FL
National Provider Identifier
1992614929
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11050200 Issued in FL
Practice address
1934 SW Newport Isles Blvd
Port St Lucie, FL 34953-4585
Phone
(954) 770-0410
NPI assigned
Sep 4, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11050200 FL Primary

Addresses

Primary practice location

1934 SW Newport Isles Blvd
Port St Lucie, FL 34953-4585

Mailing address

1934 SW Newport Isles Blvd
Port St Lucie, FL 34953-4585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1992614929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1934 SW NEWPORT ISLES BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349534585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1934 SW NEWPORT ISLES BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349534585",
            "telephone_number": "954-770-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSIER",
        "first_name": "DAVENE",
        "middle_name": "ALEXANDRA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-04",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11050200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.