Individual
MRS. CAROLINE LOUISE DERRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
15855 19 MILE RD, CLINTON TOWNSHIP, MI 48038-3504
(586) 203-1195
Mailing address
15674 GROSVENOR LN, MACOMB, MI 48044-1518
(586) 943-3999
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704234693
MI
Other
Enumeration date
12/05/2006
Last updated
02/02/2021
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