Lauren C Derrick, NP
Nurse Practitioner, Adult Health in Liverpool, NY. Individual provider (NPI-1).
NPI number1669470951
StatusActive
Last updated in NPPESSep 26, 2019
Details
- NPI
- 1669470951
- Entity type
- Individual (NPI-1)
- Name
- Lauren C Derrick
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 11, 2005
- Last updated
- Sep 26, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LA2200X | Nurse Practitioner, Adult Health | 301621 | NY | Yes |
Practice location
5112 W Taft Rd Ste JLiverpool, NY 13088-4866
Phone 315-701-2170 · Fax 315-701-2185
Mailing address
510 Towne DrFayetteville, NY 13066-1331
Phone 315-663-0500 · Fax 315-663-0514
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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