Individual
DEREK DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPSGT, CNA, FCMT, BS
Contact information
Practice address
523 N PINE ST., GUNNISON, CO 81230-2615
(970) 746-6387
(970) 832-9287
Mailing address
4 WILLOW LN, GUNNISON, CO 81230-9762
(970) 746-6387
(970) 832-9287
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
—
—
246Z00000X
Other Specialist/Technologist
Primary
24531
CO
247200000X
Other Technician
—
—
374K00000X
Religious Nonmedical Practitioner
—
—
374U00000X
Home Health Aide
NA.00764940
CO
376K00000X
Nurse's Aide
NA.00764940
CO
Other
Enumeration date
04/27/2023
Last updated
08/18/2023
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