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Individual

MS. AMY MARIE DERRICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
2640 HIGHWAY 70 STE 201, MANASQUAN, NJ 08736-2609
(327) 202-0622
(732) 202-0620
Mailing address
448 LUKAS BLVD, MORGANVILLE, NJ 07751-9741
(732) 598-0340

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR18163900
NJ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ14857300
NJ

Other

Enumeration date
12/02/2021
Last updated
10/24/2023
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