Individual
MISS KELLY R DERINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
285 MEDICAL CENTER DR, PADUCAH, KY 42003-7912
(270) 441-4343
Mailing address
285 MEDICAL CENTER DR, PADUCAH, KY 42003-7912
(270) 441-4343
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1097839
KY
363L00000X
Nurse Practitioner
3006215
KY
363LF0000X
Family Nurse Practitioner
Primary
3006215
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000632043
ANTHEM
KY
05
—
7100098570
—
KY
Enumeration date
09/02/2009
Last updated
05/31/2024
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