Provider Demographics
NPI:1801422969
Name:NICASIO, DEBORAH (DNP, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:NICASIO
Suffix:
Gender:
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 1ST AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-8607
Mailing Address - Country:US
Mailing Address - Phone:727-350-1234
Mailing Address - Fax:727-350-1235
Practice Address - Street 1:3000 1ST AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-8607
Practice Address - Country:US
Practice Address - Phone:727-350-1234
Practice Address - Fax:727-350-1235
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-19
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9391301163W00000X
FL11007573363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse