Provider Demographics
NPI:1013583277
Name:GOULET, DEANNA (APRN-BC)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:GOULET
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 OSCEOLA DR STE 222B
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-5075
Mailing Address - Country:US
Mailing Address - Phone:772-486-0186
Mailing Address - Fax:772-460-8808
Practice Address - Street 1:900 OSCEOLA DR STE 222B
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-5075
Practice Address - Country:US
Practice Address - Phone:772-486-0186
Practice Address - Fax:772-460-8808
Is Sole Proprietor?:No
Enumeration Date:2021-05-28
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11013396363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner