Provider Demographics
NPI:1740083724
Name:RETTE, XANA FERREIRA (APRN)
Entity type:Individual
Prefix:
First Name:XANA
Middle Name:FERREIRA
Last Name:RETTE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:XANA
Other - Middle Name:JULIA-PIRES
Other - Last Name:FERREIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:14 OFFICE PARK DR STE 6
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-3830
Mailing Address - Country:US
Mailing Address - Phone:386-283-7240
Mailing Address - Fax:
Practice Address - Street 1:14 OFFICE PARK DR STE 6
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-3830
Practice Address - Country:US
Practice Address - Phone:407-299-7333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-27
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11037904363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner