Provider Demographics
NPI:1407632706
Name:DIONNE, KARLEY LYNN (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:KARLEY
Middle Name:LYNN
Last Name:DIONNE
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:293 NW PEACOCK BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-2222
Mailing Address - Country:US
Mailing Address - Phone:772-336-6601
Mailing Address - Fax:772-446-7681
Practice Address - Street 1:293 NW PEACOCK BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-2222
Practice Address - Country:US
Practice Address - Phone:772-336-6601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-04
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11028396363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner