MEDICARE: MRS. YVONNE DERICKSON ARNP, FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	ARNP9228240	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME100176	OTHER	FL	LICENSE NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003341280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. YVONNE DERICKSON ARNP, FNP-BC

Provider Business Mailing Address
First Line	:	206 ASHOURIAN AVE STE 209
Second Line	:
City	:	SAINT AUGUSTINE
State	:	FL
Zip	:	32092-5107
Country	:	US
Telephone Number	:	904-742-2157
Fax Number	:	904-299-4116

Provider Business Practice Location Address
First Line	:	206 ASHOURIAN AVE STE 209
Second Line	:
City	:	ST AUGUSTINE
State	:	FL
Zip	:	32092-5107
Country	:	US
Telephone Number	:	904-800-7246
Fax Number	:	904-299-4116

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2017
Last Update Date	:	12/29/2025

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Directions to “ MRS. YVONNE DERICKSON ARNP, FNP-BC” Practice Location

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