Provider Demographics
NPI:1972167716
Name:PIERRE, DJEPHLIE CALIXTE (FNP)
Entity type:Individual
Prefix:
First Name:DJEPHLIE
Middle Name:CALIXTE
Last Name:PIERRE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:DJEPHLIE
Other - Middle Name:CALIXTE
Other - Last Name:PIERRE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:6767 SUMMIT VISTA CT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32259-7046
Mailing Address - Country:US
Mailing Address - Phone:904-416-7273
Mailing Address - Fax:
Practice Address - Street 1:1100 CESERY BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-5674
Practice Address - Country:US
Practice Address - Phone:904-416-7273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-26
Last Update Date:2023-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11002224363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily