Provider Demographics
NPI:1649526914
Name:SEBASTIAN, NICY (ARNP)
Entity type:Individual
Prefix:
First Name:NICY
Middle Name:
Last Name:SEBASTIAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:NICY
Other - Middle Name:
Other - Last Name:BABY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:2510 CULBREATH COVE CT
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33596-6387
Mailing Address - Country:US
Mailing Address - Phone:813-716-9064
Mailing Address - Fax:
Practice Address - Street 1:2510 CULBREATH COVE CT
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596-6387
Practice Address - Country:US
Practice Address - Phone:813-716-9064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9214717363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily