MRS. MARY ANNE DERRICO APRN-CNP NPI 1245581974

NPI Information

NPI: 1245581974
Provider Name: MRS. MARY ANNE DERRICO, APRN-CNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
13631 NE TOWNLEY RD
ELGIN, OK
ZIP 73538
Phone: (580) 512-0746
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MRS. Mary Anne Derrico, APRN-CNP is a family nurse practitioner in Elgin, OK with 12 years of experience. MRS. Mary Anne Derrico, APRN-CNP NPI is 1245581974. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

13631 NE TOWNLEY RD
ELGIN, OK
ZIP 73538-705
Phone: (580) 512-0746
Fax: (580) 250-0506

The NPI 1245581974 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/20/2012 and was last updated on 3/8/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	49043	OKLAHOMA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	45113	OTHER	OKLAHOMA	OKLAHOMA STATE BUREAU OF NARCOTICS AND DANGEROUS DRUG CONTROL REGISTRATION NUMBE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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