Individual
MARY M DERKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS
Contact information
Practice address
12265 JAMES ST, HOLLAND, MI 49424-8613
(616) 494-5453
Mailing address
12265 JAMES ST, HOLLAND, MI 49424-8613
(616) 494-5453
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704158809
MI
Other
Enumeration date
07/26/2006
Last updated
02/13/2012
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