Provider Demographics
NPI:1750054177
Name:DUARTE, THAYSA COSTA (FNP, NP-C)
Entity Type:Individual
Prefix:MS
First Name:THAYSA
Middle Name:COSTA
Last Name:DUARTE
Suffix:
Gender:F
Credentials:FNP, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 E 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36542-3516
Mailing Address - Country:US
Mailing Address - Phone:251-948-4290
Mailing Address - Fax:251-948-7682
Practice Address - Street 1:156 E 15TH AVE
Practice Address - Street 2:
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542-3516
Practice Address - Country:US
Practice Address - Phone:251-948-4290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-30
Last Update Date:2024-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-137309363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily