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NPI Code Detail

MEDICARE: ASTY CARLETTE DUVERSONNE

MEDICARE: ASTY CARLETTE DUVERSONNE
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
1363LF0000XFamily Nurse PractitionerAPRN1171274TX

General Provider Information

NPI Number : 1861165995
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASTY CARLETTE DUVERSONNE
Provider Business Mailing Address
First Line : 2735 SW 8TH ST APT 2
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33312-2142
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4400 OAK PARK LN
Second Line :
City : FORT WORTH
State : TX
Zip : 76109-9534
Country : US
Telephone Number : 817-985-7772
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2021
Last Update Date : 01/14/2026

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Directions to “ ASTY CARLETTE DUVERSONNE ” Practice Location

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