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General NPI Number Information
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NPI Number | 1982903621
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Entity Type | Individual
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Provider Name | DEEDEE CARTER-SAKS LNP, DNP
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Gender | Female
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Dates
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Enumeration Date | 03/21/2011
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Last Update Date | 12/14/2020
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Provider Practice Location Address
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Address Line | 11363 SAN JOSE BLVD STE 102B
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City | JACKSONVILLE
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State | FL
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Zip | 32223-7958
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Country | US
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Telephone | 904-288-8994
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Fax | 904-288-8995
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Provider Business Mailing Address
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Address Line | 4909 BLACKHAWK DR
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City | SAINT JOHNS
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State | FL
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Zip | 32259-2171
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Country | US
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Telephone | 414-916-1827
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Fax |
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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 | 9461377
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License Number State | FL
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