Provider Demographics
NPI:1669352837
Name:DERVIL, PIERRE ANTOINE (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:PIERRE ANTOINE
Middle Name:
Last Name:DERVIL
Suffix:
Gender:M
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1386 SW GRANVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-2201
Mailing Address - Country:US
Mailing Address - Phone:953-534-6051
Mailing Address - Fax:
Practice Address - Street 1:1386 SW GRANVILLE AVE
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-2201
Practice Address - Country:US
Practice Address - Phone:953-534-6051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-06
Last Update Date:2025-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11041582363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily