Provider Demographics
NPI:1386369650
Name:STOVALL, NIKEA S (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:NIKEA
Middle Name:S
Last Name:STOVALL
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:601 S HARBOUR ISLAND BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-5925
Mailing Address - Country:US
Mailing Address - Phone:727-322-3439
Mailing Address - Fax:
Practice Address - Street 1:727 SEBASTIAN BLVD UNIT B-1
Practice Address - Street 2:
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-4375
Practice Address - Country:US
Practice Address - Phone:772-202-0946
Practice Address - Fax:772-202-5395
Is Sole Proprietor?:No
Enumeration Date:2022-10-07
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL11020286363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily