Individual
MICHELLE L. DERBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Contact information
Practice address
1207 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-8575
(859) 258-8562
Mailing address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-6200
(859) 258-6203
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA349
KY
363AM0700X
Medical Physician Assistant
PA349
KY
363AS0400X
Surgical Physician Assistant
PA349
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95003463
—
KY
Enumeration date
10/05/2006
Last updated
04/08/2025
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