Individual
DEREK MAYNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3017779
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2022
Last updated
06/03/2022
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