Vanessa Lynn Derner, LAT, ATC, ACSM-EP
Specialist/Technologist, Athletic Trainer in Yuma, AZ. Individual provider (NPI-1).
NPI number1962012575
StatusActive
Last updated in NPPESMar 15, 2023
Details
- NPI
- 1962012575
- Entity type
- Individual (NPI-1)
- Name
- Vanessa Lynn Derner
- Credential
- LAT, ATC, ACSM-EP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 7, 2020
- Certification date
- Mar 15, 2023
- Last updated
- Mar 15, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | ATR-009312 | AZ | Yes |
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – |
Practice location
2020 S Avenue 8 EYuma, AZ 85365-6900
Phone 402-672-6025
Mailing address
710 Eagle View DrPapillion, NE 68133-2482
Other practice locations
710 Eagle View Dr
Papillion, NE 68133-2482
Papillion, NE 68133-2482
Phone 402-672-6025
3061 S Melanie Dr
Yuma, AZ 85365-5112
Yuma, AZ 85365-5112
Phone 402-672-6025
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