Individual
KRYSTINA DERRICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPM
Contact information
Practice address
1901 S 9TH ST, PHILADELPHIA, PA 19148-2384
(609) 436-5769
(609) 751-0905
Mailing address
419 S DUNCAN ST, BALTIMORE, MD 21231-2740
(609) 436-5769
(609) 751-0905
Taxonomy
Speciality
Code
Description
License number
State
175M00000X
Lay Midwife
Primary
25MW00003300
NJ
Other
Enumeration date
06/07/2016
Last updated
05/20/2024
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