Individual
JENNA ELIZ TAN DERIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAA
Contact information
Practice address
1200 PECAN ST SE, WASHINGTON, DC 20032-2652
(202) 823-4220
Mailing address
2300 M ST NW FL 7, WASHINGTON, DC 20037-1434
(202) 823-4220
(202) 823-4221
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
—
—
Other
Enumeration date
05/22/2025
Last updated
05/22/2025
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