Provider Demographics
NPI:1962121095
Name:SANDERS, STEVEY ELYSE (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:STEVEY
Middle Name:ELYSE
Last Name:SANDERS
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:STEVEY
Other - Middle Name:ELYSE
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3445 BANNERMAN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-7053
Mailing Address - Country:US
Mailing Address - Phone:850-894-2401
Mailing Address - Fax:850-894-2779
Practice Address - Street 1:3445 BANNERMAN RD STE 100
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32312-7053
Practice Address - Country:US
Practice Address - Phone:850-894-2401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF07221856363LP2300X
FLAPRN11022442363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care