Individual
AMANDA DERBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(919) 784-3100
Mailing address
3100 SPRING FOREST RD, SUITE 130, RALEIGH, NC 27616-2880
(919) 882-0795
(919) 873-9821
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
282890
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
109837
NC
Other
Enumeration date
03/02/2016
Last updated
07/01/2016
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