Individual
KAITLYN NICOLE DERVENIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
493 WESTFIELD RD, NOBLESVILLE, IN 46060-1303
(317) 848-0361
Mailing address
5889 SANDALWOOD DR, CARMEL, IN 46033-8216
(317) 363-9788
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71015363A
IN
Other
Enumeration date
01/23/2024
Last updated
09/30/2024
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