Provider Demographics
NPI:1104483700
Name:NEVINS, FELICIA KRYSTYN
Entity type:Individual
Prefix:MRS
First Name:FELICIA
Middle Name:KRYSTYN
Last Name:NEVINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FELICIA
Other - Middle Name:KRYSTYN
Other - Last Name:STOKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7229 TOUCAN TRL
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-2757
Mailing Address - Country:US
Mailing Address - Phone:352-678-9930
Mailing Address - Fax:
Practice Address - Street 1:175 MIDDLE ST UNIT 1201
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3625
Practice Address - Country:US
Practice Address - Phone:866-610-0581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician