Provider Demographics
NPI:1184255598
Name:DESLIENS, CLAIRE MONIQUE (NP)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:MONIQUE
Last Name:DESLIENS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 LANCASTER WAY
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33414-4355
Mailing Address - Country:US
Mailing Address - Phone:561-908-4227
Mailing Address - Fax:
Practice Address - Street 1:123 LANCASTER WAY
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33414-4355
Practice Address - Country:US
Practice Address - Phone:561-908-4227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11005899363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner