Provider Demographics
NPI:1376255489
Name:SELLERS, DEBORAH GAIL (PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:GAIL
Last Name:SELLERS
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 COLLINS LANDING RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32310-8272
Mailing Address - Country:US
Mailing Address - Phone:850-545-0052
Mailing Address - Fax:
Practice Address - Street 1:1616 PHYSICIANS DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4619
Practice Address - Country:US
Practice Address - Phone:850-431-0892
Practice Address - Fax:850-431-6728
Is Sole Proprietor?:No
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11023633363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health