Provider Demographics
NPI:1427899418
Name:MCKEE, SEVANISTA D (APRN)
Entity type:Individual
Prefix:
First Name:SEVANISTA
Middle Name:D
Last Name:MCKEE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SEVA
Other - Middle Name:D
Other - Last Name:MCKEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:113 SEA GROVE MAIN ST UNIT 201
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-3307
Mailing Address - Country:US
Mailing Address - Phone:904-514-8478
Mailing Address - Fax:
Practice Address - Street 1:1000 PLANTATION ISLAND DR S STE 9
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-3106
Practice Address - Country:US
Practice Address - Phone:904-460-9191
Practice Address - Fax:904-471-4859
Is Sole Proprietor?:No
Enumeration Date:2024-06-04
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11034427363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily