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MRS. NANCY DIANE DEROSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
289 IRELAND AVE, FORT KNOX, KY 40121-5111
(502) 624-9007
Mailing address
4540 WOOLDRIDGE FERRY RD, ELIZABETHTOWN, KY 42701-6136
(270) 737-4832

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
4590P
KY

Other

Enumeration date
08/12/2006
Last updated
07/08/2007
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