# JENNIFER L DERRICK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1700083680
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | 50807 | MN | — |
| 207PH0002X | Hospice and Palliative Medicine (Emergency Medicine) Physician | 50807 | MN | — |
| 2086H0002X | Hospice and Palliative Medicine (Surgery) Physician | 102956-875 | WI | — |
| 2086H0002X | Hospice and Palliative Medicine (Surgery) Physician | 50807 | MN | Yes |

## Other

- **Enumeration date:** 07/02/2007
- **Last updated:** 07/18/2025