Provider Demographics
NPI:1083204077
Name:GASPARD, DIASMENE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:DIASMENE
Middle Name:
Last Name:GASPARD
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:571 SE CALMOSO DR
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-2158
Mailing Address - Country:US
Mailing Address - Phone:772-240-8892
Mailing Address - Fax:
Practice Address - Street 1:571 SE CALMOSO DR
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-2158
Practice Address - Country:US
Practice Address - Phone:772-240-8892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11011165363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care