Wislande Derose
Nurse Practitioner, Family in North Babylon, NY. Individual provider (NPI-1).
NPI number1023969698
StatusActive
Last updated in NPPESFeb 9, 2026
Details
- NPI
- 1023969698
- Entity type
- Individual (NPI-1)
- Name
- Wislande Derose
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 9, 2026
- Certification date
- Feb 8, 2026
- Last updated
- Feb 9, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | F356190-01 | NY | Yes |
Practice location
106 Elkton LnNorth Babylon, NY 11703-2905
Phone 347-856-0086
Mailing address
106 Elkton LnNorth Babylon, NY 11703-2905
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