Healthcare Provider Details

I. General information

NPI: 1124955893
Provider Name (Legal Business Name): DEANNA MICHELLE SEVIER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1537 N SINGLETON AVE
TITUSVILLE FL
32796-1679
US

IV. Provider business mailing address

PO BOX 1137
MELBOURNE FL
32902-1137
US

V. Phone/Fax

Practice location:
  • Phone: 321-241-6800
  • Fax: 321-241-6890
Mailing address:
  • Phone: 321-241-6800
  • Fax: 321-241-6890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11047759
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: