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Individual
MR. MILES COLISON DERRICK
Active
Individual
MR. MILES COLISON DERRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
101.0138018
VT
Other
Enumeration date
08/24/2017
Last updated
08/06/2025
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