Tammy Marie Derenick, RN
Registered Nurse, General Practice in Dickson Cty, PA. Individual provider (NPI-1).
NPI number1932932142
StatusActive
Last updated in NPPESAug 22, 2024
Details
- NPI
- 1932932142
- Entity type
- Individual (NPI-1)
- Name
- Tammy Marie Derenick
- Credential
- RN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 22, 2024
- Certification date
- Aug 22, 2024
- Last updated
- Aug 22, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WG0000X | Registered Nurse, General Practice | RN767231 | PA | Yes |
Practice location
1550 Main StDickson Cty, PA 18447-1345
Phone 570-550-0870
Mailing address
1550 Main StDickson Cty, PA 18447-1345
Phone 570-550-0870
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