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General NPI Number Information
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NPI Number | 1376990796
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Entity Type | Individual
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Provider Name | GHAYATHRI ANANTHI DEVARAJ NP
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Gender | Female
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Dates
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Enumeration Date | 05/16/2016
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 1506 S FRENCH AVE
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City | SANFORD
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State | FL
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Zip | 32771-3374
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Country | US
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Telephone | 321-257-0489
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Fax | 321-257-0491
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Provider Business Mailing Address
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Address Line | 1506 S FRENCH AVE
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City | SANFORD
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State | FL
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Zip | 32771-3374
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Country | US
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Telephone | 321-257-0489
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Fax | 321-257-0491
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP130588
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11031750
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License Number State | FL
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