Individual
DERRICK CEPHANO GLYMPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2301 ERWIN RD, DURHAM, NC 27705-4699
(919) 684-8111
Mailing address
PO BOX 110566, DURHAM, NC 27709-5566
(919) 620-4855
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
1440339
FL
367500000X
Certified Registered Nurse Anesthetist
24166459
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
354458
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010156238
—
VA
Enumeration date
08/21/2006
Last updated
07/24/2023
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